How does diabetes stand by you?

"How does diabetes stand by you?" I find metaphors useful in describing diabetes concepts and our approaches to self-care. One I often evoke with patients is "how do you walk with diabetes"? In my experience as a person with diabetes for a half century, and as a Diabetologist, I can say that there are only three ways we "walk" with our condition. We journey through our lives with diabetes always nearby. That is not a choice, but a fact. However, where we position ourselves relative to our condition IS a choice. Read on.

A common position is to place our diabetes behind us, out of emotional sight. "Huh? What diabetes"? you might say or think to yourself. In ignoring or denying our disease we are prone to ignore many (if not all) of the essential tasks necessary to keep it reasonably controlled. This is the most dangerous of the three positions. After all, denial is the first response to dealing with things we feel are out of our immediate control. We hide in plain sight. In putting diabetes behind us (figuratively speaking) our self care choices are directly affected. Missing a scheduled insulin dose or oral medication, omitting a blood sugar check, overeating, and missing doctor check ups are just a few obvious examples of taking the "out of sight, out of mind" stance.

The second position is placing diabetes directly in front of us, like an impenetrable barrier. "I can't do that (fill in the blank) because I'm a diabetic" is a common expression reflecting this attitude. Rarely is it justified. Using our diabetes as an excuse to not act only serves to foster a "can't do" attitude than erodes self esteem and personal initiative. Over my decades of living with diabetes I have been blessed to meet many accomplished people with diabetes who didn't let the disease block their path to the goals they set for themselves. This list of diabetes 'doers' is considerable. No doubt it includes some of the persons reading this post now.

The third, and without question the most desirable position to place diabetes is...at our side. Whilst we did not choose this partnership, the best course of action is to make peace with it (if needed) and learn as much as possible to tame it. Like a wild beast at first, diabetes can and must be corralled. This is often a team effort at first and should best remain that way as time moves forward. The legendary father of diabetes education, Dr. Elliot P. Joslin, used the metaphor of 3 wild horses which the person with diabetes must tame and harness in order to pull the chariot of good control.

Hopefully your diabetes is more like a companion. Many of you might see it more as a cantankerous cat with a mind of its own. Either way it's vital that an atmosphere of respect is created in order for both parties to move forward and for you or your child to realize his or her goals and potential.

Of these three locations: behind us (denial), before us (obstructing) or aside us (acceptance and tamed), most of us will try out all three positions over the arc of our lives. Often interchangeably. This is completely understandable. I have certainly been there. The loved ones around us are who really need to understand this the most. One's personal relationship with diabetes is always complicated, nuanced, and complex. I've never known it be anything else. This fact often gets overlooked by all the "third parties" in our lives: family, friends, caregivers, health care professionals and even insurers. The path to living well with diabetes is most certainly a winding road.

So has your journey with diabetes been characterized by shifting positions over time? Have you settled on the one which best works for you? Please share examples of your journey walking with diabetes.