On January 13th, 2018, I celebrated the 30th anniversary of being diagnosed with Type 1 diabetes.  World Diabetes Day (November 14th), a day that many diabetics take to social media to tell mostly uplifting stories, was celebrated this past Wednesday. Many of the stories are motivational and help others overcome obstacles, but what happens the other 364 days?

This post will focus on the following 2 primary motivations for continuing to maintain my diabetic health 30 years after being diagnosed:

‍#1. Natural Selection

#2. Everything involving my Diabetes is my Responsibility

‍If you would like to learn more about my diabetic history, my thoughts on current treatments, etc., I invite you to read Ascending Diabetes: Trial, Error and keeping it simple (published in September 2018).

‍#1 NATURAL SELECTION‍

There are many laws that govern the natural world, one of them is Natural Selection. According to Wikipedia, Natural Selection is defined as the process by which individual organisms with favorable traits are more likely to survive and reproduce. If you would like to read more, you can review this article and/or watch the following informational video on YouTube. In general, Natural Selection is the process by which a species continues to remain hereditarily strong through reproduction and also allows them to evolve to their environment.

No matter your feelings on how and why you were diagnosed, if you have diabetes, you have been Naturally Selected. This means that due to certain “unfavorable” traits, nature has predetermined that your fate should be to die from diabetes and not reproduce. With the advent of modern medicine (insulin, meters, pumps, CGMs, etc.), diabetics can fend off natural selection and live long, healthy, and mostly normal lives. If you were born into most any other species and developed type 1 diabetes, you would not survive long. Maybe slightly longer if type 2. This seems harsh, but when you accept it as factual information, you become highly motivated to do everything in your power to beat natural selection. A diabetic’s war against natural selection is our greatest struggle. Some battles you will win and some you will lose, but your goal should always be to win most of the time.

Dying is usually never a fun topic. Male type 1 diabetics have an average life expectancy of about 66 years, compared with 77 years among men without type 1. Female type 1 diabetics have an average life expectancy of about 68 years, compared with 81 years for those without type 1. Type 2 life expectancy is harder to determine given the other health concerns normally associated with type 2 patients; however, all type 2 diabetics have a shorter life expectancy than normal folks.  

If you can view the idea of natural selection, your blood sugar results, A1c results, etc. as information to determine treatment and not associate them as “good” or “bad,” you can be better prepared to make the right decisions for your diabetes. Using Natural Selection as a motivator is also an effective way to keep from becoming a victim of your disease. If you become a victim, nature will run its course. If you are the parent or caregiver for someone with diabetes, your goal will be to prepare them to be as independent as possible, so they too can be prepared to battle against the forces of natural selection for the rest of their lives.

I view 66 years as a challenge and as a result, I exercise daily, eat a healthy diet, check my blood sugar often, see my doctor regularly, and take my insulin as needed. Every diabetic should view each waking day as a privilege and value the tools that are available to them to continue to wage war against natural selection. ‍

‍#2 EVERYTHING INVOLVING MY DIABETES IS MY RESPONSIBILITY

‍Whenever anyone discusses someone “taking responsibility” for their actions, it is not normally something that had a positive outcome.

To my knowledge, no type 1 diabetic is responsible for their diagnoses, and the overwhelming majority of type 2 diabetics are directly responsible for their diagnoses. No one chooses to be diabetic. Placing blame on the individuals for their diagnoses serves no purpose; however, what that individual does post diagnoses is entirely their responsibility.

If you are diabetic or have a friend that is diabetic, perform this simple task. Stand in front of a mirror, look yourself in the eyes, and repeat the phrase, “I am entirely responsible for my actions and the consequences associated with them.” It is very easy to take credit for the goods things that happen in life and in many cases, much easier to blame others or “the system” for the consequences of bad decisions.

‍Here are a few examples that bring the idea of diabetic responsibility into reality:

#1. A diabetic male of 20 years, 12 years with type 1, decides to go out one night. He chooses to drink too much, comes back to his dorm room, fails to check his blood sugar or eat anything prior to going to bed, and wakes up with EMS standing over him due to a low blood sugar seizure. The seizure is not his fault because he was not directly the cause of his type 1 diabetes; however, it is his responsibility to manage his health and make good decisions. Fortunately, this was not a life-threatening situation since his friends found him and obviously called 911. Assessing or accepting blame in this situation serves no purpose. This individual was best served by realizing that if he decides to go out and partake in a few drinks, it would be a good idea to check his blood sugar and if necessary, eat something prior to going to bed despite his intoxication level.  Fortunately, I learned from my mistake, and from then on, never had another seizure after going out with friends.

‍#2. A female around 10 years ago, diabetic for several years, is invited to stay at a friend’s house. During the night, her blood sugar drops, she has a diabetic seizure or episode, and unfortunately passes away from the resulting complications. Whenever someone passes away from events related to type 1 diabetes, assigning fault or blame is pointless; however, in this case, the blame seemed to be assigned to the actual disease itself. “Diabetes is to blame.” This makes absolutely no sense and does no good whatsoever for the family or the diabetes community. It is very easy to associate emotion with lots of diabetic information especially when it comes to the death of a little girl. In this case, it would be much better to say, “what can we learn from this unfortunate event so that it does not happen again?”

I remember being diagnosed in 2nd grade and not being allowed to sleep over at anyone’s house until sometime during 3rd grade. Even then, my mom went over to my friend’s home and explained to his parents what do if _____ (this) happens. This meeting took several hours and fortunately, my friend’s parents were acceptable to this “sick kid” staying over and nothing bad ever happened, but they always reminded me to check my blood sugar prior to going to bed.  I learned later that his parents always called my mom to report back and see if they needed to do anything. I also recalled often being asked to drink a juice or eat a few cookies prior to going to bed.

‍#3. A male around 24 years old, diabetic for 16 years, is struggling to pay for his insulin. He chose to take a seasonal job that does not offer full time health coverage but is a good stepping stone for his career. During this period with no health insurance, he pays out of pocket for his insulin, and puts most of these high cost expenses on credit cards. After a period of 2 years, he has racked up a fair amount of debt. Fortunately, he learns that this job is not a good long-term option, accepts another position with benefits, and over time, is able to pay off the mountain of medical debt. This was also a difficult time in my life. Being diabetic caused me to make different decisions that were not good or bad. They were the decisions made based on the available information at that time. I learned the hard lesson of “do not take a job that does not offer health coverage unless you can afford to pay for health coverage on the open market.” You can attempt to assign blame to "the system" but it does not change whom is responsible for an individual's disease.

‍Regardless of the outcome, all diabetics should be fully responsible for their decisions. Remember, if natural selection had its way, you would be dead. Therefore, enjoy your life, learn from your decisions (especially if your diabetic), and #liveresponsibly.

If you want to have a constructive conversation about this or anything else, message me, and let's grab coffee or a beer.

Have a good one,

Dan