Is Diabetes a Disability?

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As I got ready to go to the doctor’s office yesterday, I handed my Milan Marathon registration form to my wife Jess, and asked her to fill it out for me.  “They’ll never be able to read my handwriting,” I said.  In order to participate in the marathon I need a certificate of health signed by a sports doctor.  It’s not supposed to be a big deal, but I was stressed about going for a physical exam. 

I watched Jess write my basic information on the form.  At the end of the page there was a space devoted to “disability.”  Jess looked up.

“Do I write diabetes? Is diabetes a disability?” she asked.  She and I both have autoimmune diabetes. 

“Don’t write anything.” 

We were both thinking the same thing.  Diabetes is not a disability. 

Or is it? 

“We’ll let the doctor fill that part in,” I said.

That blank line on a simple form shouldn’t have meant anything.  It should have come and gone like every other form I’ve ever completed.  Instead, it filled my mind with identity questions.  I think of myself as diabetic, or a person with diabetes, if you prefer, not as disabled.  But yet, if my insulin pump were to fall off during a marathon, or if my blood sugar began to plummet, I’d probably be the most disabled guy on the course.

I was nervous on my way to the doctor’s.  I questioned whether I’m really healthy and worried the doctor would tell me that I’m not.  Maybe he wouldn’t sign the form because of my diabetes. I know plenty of people with type 1 diabetes run marathons and although I myself have run many, I always have a fear that I won’t be allowed in.  Or perhaps there will be some official at the starting line who spots my insulin pump and pulls me aside just as the race begins.

In the clinic I filled out a long questionnaire and went in to see to the doctor, a pale, slightly overweight man in his 50s with a very heavy French accent that made his mumbling difficult to understand. The first thing I told him when I walked in was that I needed a certificate signed for the Milano City Marathon.  Then I said, “I have type 1 diabetes.”  It came out more like a declaration than an ordinary sentence.   The doctor asked me all the usual medical questions and sent me to the next room to test my lung capacity. Next, I ran on a treadmill while hooked up to a heart monitor.  For 30 minutes a nurse continuously raised the incline and speed.  

When the physical tests were over I returned to the doctor’s office. He looked at my results, mumbling things I couldn’t understand, and then he asked me what I carry with me when I run.

“Energy gels,” I said.

“You don’t carry glucagon?” he asked.  Finally, he was speaking clearly.

“No,” I said.  Glucagon?  Seriously? How the hell would I carry the orange box, along with the glucose meter and gels.  And even if I did carry it and passed out, would anyone who found me know what it was or how to use it?

“Do you run with ID of some sort?” the doctor asked.

I understood his question perfectly, but since the honest answer would make me sound very negligent, I said, “Excuse me?”

He repeated the question, adding, “If something happens to you, how will anyone know you have diabetes?”

I showed him my pump and said, “I have an insulin pump.”

“It won’t be visible and many people don’t know what it is.  They’ll think it’s a pager or a phone.  You need ID.”

I shrugged.  He was right. What would happen to me in Milan, where I know no one, if I passed out?

The doctor completed the Milano City Marathon health form and I held my breath when he got to the line Jess had left blank. Under the word ‘disability’ he wrote “Diabetes (DID) Insulin”.

Although I was expecting that to happen, I was disappointed to see it written down. I don’t know if my face gave it away or if  the doctor just understood how it must feel to have that line not left blank.  He mumbled again.  This time his words were apologetic.  He was sorry he had to write it down.

Before leaving the office, I turned to the doctor and in a pathetic kind of way asked, “I’m healthy, right? Fit to run?”

I don’t know what I was hoping for, or why I even asked.  The doctor’s reaction was not very reassuring.  He replied with a weak,“yes.”

At home I sent the form to the marathon organizers   I also ordered medical ID from, roadid.com.  I chose an ankle ID, which can also be used for a timing chip, and dog tags. (I decided I wouldn’t feel comfortable with the bracelet.)   Though I’d been to the road ID site many times before, and had even designed my ID.  I’d never gone through with ordering it.

But now I’ve done it.  I’ve done the safe and responsible thing. Surprisingly, it doesn’t feel bad.  I don’t feel as though I’ve just labeled myself disabled.

I know I can and will run the Milano City Marathon, but I also know that I will continue to feel like someone escaping under the radar.  I’m a person with an invisible disability.  No matter what you call it, it’s always there.

Michael Aviad is co-founder of ASweetLife.  He writes the blog Diabetes – It’s an Endurance Sport.

Follow Michael on Twitter @michaelaviad

 

Comments (7)

  1. Caitlin Rufo-McCormick at

    Great post, as usual!  I think most people diagnosed with disabilities – whether it’s diabetes, autism, or deafness – hate to think of themselves as disabled. “Disabled” is a phrase that shuts us out of places, declaring we can’t do something, but that’s rarely the case. It’s all about the mindset!  Keep running – though a road ID is a great thing.

  2. Great post, Michael. 

    It’s a question that really brings pause for many of us, isn’t it? Like Caitlin said, we don’t want to feel like we can’t do something. I also very much appreciated you sharing the awkward interaction with the doctor. Seems he was in an uncomfortable place with it, too.

  3. Jennifer Jacobs
    Jen J. at

    I’ve grappled with this before too. I think it’s fair to say that people with diabetes are both able and disabled. Depending on the variables, we can be on both ends of the spectrum in any given day (or hour!). You will do great with your marathon, good luck!   

  4. Interesting … I had the exact same thought process last week when filling out the registration for the Chicago marathon. I was expecting to see a section for any ‘Medical Conditions’ – this is fairly standard on most race registration forms I’ve seen. Instead however, I see a field for ‘Have you any Disabilities’. This made me stop and think. I certainly don’t count my diabetes as a disability so I decided to leave this blank. I wonder whether Milan and Chicago are using the same registration provider (Active Global for Chicago), and whether their use of the term ‘disability’ on the form is supposed to be a catch all for any kind of medical issue – if so I think its very badly worded, somewhat inappropriate, and very confusing.
    As for race day, I use a VitalID wristband with medical details and ICE contact number, and sometimes write ‘Type1 Diabetic’ on the back of my number.
    Best of luck with Milan.

  5. In Israel diabetics can register as 20% disabled.  I am a little hesitant to do so for the reasons mentioned above, plus I am unclear on what it entitles me to.

    Michael, did you go to a doctor that you knew wouldn’t have a problem with an english form.  Or will any doctor do? 

  6. Scott at

    Good for you.  I have never run a marathon, but I have toured on a bicycle by myself when I was younger.  My parents and friends thought I was crazy.  This was before pumps.  I have managed up to a 1000 mile tour in 14 days, without any DM incidents, other than minor low BG’s.  I would like to try some longer tours again, but I will have to take one or more of my sons with me, for my spouse’s agreement.
    You are only limited by your own imagination.

  7. Zip at

    I think you will love your RoadID.  I have one and love it and it makes me feel a bit safer when I’m cycling.  Way to go on the marathon — wow!!

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