There is a tightrope lined with carbohydrate counts, mileage trackers, and bottles of metformin. This once elastic tightrope is starting to fray, with fears of it breaking any moment. When will all the diet, exercise, and metformin no longer be enough?
Thirteen of my forty-two years have been spent walking this tightrope named type 2 diabetes. No complications so far, despite plenty of errors. A recent shoulder injury brought up the dreaded “frozen shoulder” question, and there have been held breath moments in recent years at the ophthalmologist’s office as he checked my retinas just a little longer, yet still no evidence of complications.
I run. I hated running as a kid – I struggled to breathe correctly, to find the right stride. But, the type 2 diabetes diagnosis brought out my inner athlete. I found the stride that works for longer than a couple miles, surprisingly, it resulted from the strengthening exercises I used to treat that shoulder injury. I will keep running as long as my arthritic knee permits because of the feeling afterwards of accomplishment and fearlessness.
What I eat requires more of an active effort these days. More often, I find myself choosing better options when I ask myself whether I really want to eat that dessert after I know what it will do to a day of decent blood glucose readings. Meal planning is a goal, one that is still elusive, but at least mindful eating is starting to be a thing.
Speaking of mindful, alcohol is less of a thing than it used to be. Over a year ago, a combination of high physical activity, medication interactions, and alcohol intake contributed to a hypoglycemic event I would rather not repeat. I still like the taste of beer and wine, but more and more often, I find myself going weeks without a drink, then only having one or two before a few more weeks pass. It keeps weight off and blood glucose levels steadier, so I might as well keep doing what I am doing there.
I weigh future treatment decisions with the question of quality of life over quantity of life, taking into consideration the medical advice I receive while ultimately retaining the power to say yes or no. Is managing blood glucose now with a medication yet unstudied for long-term side effects going to bring on other complications later? Insulin often seems the best option when the tightrope begins to fray, threatens to break.
Diabetes has also taken a turn into financial worries, both immediate in that mad scramble to pay medical bills due to a high deductible health plan I entered this year, and towards the future as I realize how little I have saved.
I bounce back less easily from injuries, from the common cold, from diabetes care burnout. I make errors. Fears come and go. There is no protecting the tightrope from fraying – it is a matter of hoping for the best while preparing for the worst. It may break tomorrow, or it may break when least expected, or maybe if lucky enough, it will remain intact.