Should I Be Worried About My Diabetes?

Should I be worried about my type 2 diabetes (T2D)? This question pops up from time to time, and there's not always an easy answer.

I'm fortunate enough to have met a few people who have lived a very long time with diabetes, at least one of them for nearly 80 years. Richard is particularly memorable. He was diagnosed with type 1 diabetes as a child in the 1940s. At that time, his doctor told his mother to give him a shot of insulin in the morning and no sugar. That was it.

Today, Richard lives a relatively healthy, active life for someone in their 80s. The only complication he has, as he puts it, is "a little bit of neuropathy."

When people ask Richard why he's lived so long with diabetes and had so few ill effects, he says he doesn't know; maybe he's just lucky.

Living well with T2D is more than luck

Through my work and advocacy, I've met a handful of people who have lived a very long time with diabetes—like 50-plus years. And I've noticed a few things about how they manage their diabetes that might just be helping them along the way. They all talk about how much diabetes care has advanced over the years.

Adapting to advancements in diabetes care

Their early days managing diabetes included some astounding things, such as:

• Adding chemicals to their urine and boiling it to get a rough read on their glucose levels.
• Using the color of their boiled urine to decide their daily insulin dose.
• Injecting insulin with long steel needles that had to be sterilized and used again and again.

Only later, when finger-stick glucometers and A1C tests became available, could they measure their glucose levels with any accuracy. And yet they carried on. Every one of these folks acknowledges the difficulties they face managing diabetes, especially early on, but they keep at it.

As treatments and technology advanced, people changed their routines and how they managed their diabetes. They made the shift from animal-based insulin to human and human analog insulin. People replaced their steel needles with more precise single-use syringes. They adapted to doing finger stick glucose checks throughout the day. Still, later, they adopted continuous glucose monitors.

So, they kept up-to-date on how to manage diabetes. And they adapted.

Diabetes management takes resilience

"I was careless." This is how Tom described experiencing hypoglycemia (hypo). He had missed a detail in his routine that day. Next time he would do better. That was it.

No beating himself up or describing what happened as a failure or a failing. Tom talked about the experience matter-of-fact, acknowledging that he could have done something different but hadn't.

Strive for better, not perfection

There was no awfulizing the experience. Just because he went low this time didn't automatically mean irreparable damage was done. He wasn't going to lose a limb or go blind. He was going to pay better attention. He wasn't telling himself to be perfect; just do better. He moved on from the experience.

I've seen this same calm resilience in several people I've met who've lived long lives with diabetes. It's an enviable trait. But it doesn't mean that they dampen all emotion and don't have strong reactions.

Lacking proper information

Another person shared with me how angry they felt when they finally were told that scar tissue had developed because they tended to take their insulin shot in the same spot over the years. Their body wasn't responding well to insulin anymore because of this.

I wondered why their doctors or nurses never taught them about rotating shots. While they feel resentment toward their providers, they also don't let themselves get stuck there.

They adapted to this new information and began varying the placement of their insulin shots. They didn't let their anger get in the way of improving their daily self-care routine.

Which brings me back to the question of worry.

Worrying does not fuel long-term management

Do you know what I haven't seen much of among the people I've met who've lived with diabetes for a long time? Worry.

This isn't to say they don't think about or acknowledge the risks associated with diabetes; they just don't dwell on them. This isn't to say that they don't take diabetes seriously. Every one of them actively manages their diabetes and has adopted new treatments and technologies as much as possible.

But they consistently do their best (in that moment) and focus on what's good right now. So, should I be worried? Based on what I've learned from people who have lived with diabetes way longer than me, I'm going to say no.