Control

From the time I was diagnosed with T1D almost 25 years ago there was a lot of talk about control. The need to control everything: blood sugars, insulin, food, exercise, stress. Life quickly became a balancing act, adding a bit of food here, some insulin there, an attempt to reduce stress here and a hint of luck there. More than a hint of luck, it turns out, because even as I try to micromanage the variables I inevitably end up with a blood sugar above 10 almost every single day. 

It’s the desire need to control that has affected my life with diabetes more than anything else. I was diagnosed with general anxiety disorder in my early 20s, having suffered a series of panic attacks that left me afraid to leave my home. I tend not to panic with such urgency anymore as to deem it an attack but rather have a constant low level fear almost constantly. Will my blood sugar go low during a meeting and I won’t be able to excuse myself? Will I be able to achieve a good A1C and try to have a baby? Will I be dead in bed one morning? The anxiety ebbs and flows, just like my blood sugar. Stress typically raises my blood sugar. It can also lower it. Stress and diabetes are great that way. 

When I moved to Vancouver 6 years ago the anxiety was with me constantly and I thought there was something horribly wrong with me – my heart raced almost all the time, my head felt like it was detached from my body, my fingers tingled, I couldn’t breathe in deeply enough. All tests pointed to one thing: nothing. My doctor suggested anxiety each time I’d see her and each time I thought there must be something else. I didn’t feel particularly stressed except for the fact that I was feeling awful all the time. Finally, after living here for almost two years, the symptoms started to subside. It was such a relief to be able to get through a day without feeling like I was going to fall over from the strange lightheaded sensations I had experienced up until that point. It was good to be able to live again.

In retrospect, I think it all came from the loss of control. I didn’t know anyone that well when I moved here and didn’t know what would happen if I got really sick. My boyfriend (now husband) was supportive, but he didn’t know my diabetes that well back then. Would he know what to do if I had a seizure? Did he understand the seriousness of ketones? I had worked so hard in Toronto to build up a great group of friends who I educated about my disease and now I was without them. 

I find that my control issues spill into other areas of my life. I’m okay with saying I’m have OCD tendencies and that I try to be very good perfect in all I do. I think it’s because I’m always striving for perfection in my diabetes management that I push myself and others to be better, to do their best. But there needs to be balance. I need to accept that there will be days of blood sugars that reach the 20s. I need to be okay with our apartment not being sparkling clean every time a friend comes over. The fine tuning can be exhausting, so sometimes I should just let it go; be okay with being 9.4 for an hour knowing I’m not reducing my chances of a baby. Likewise, I need to give people around me a break. Know that their best today may be the equivalent of achieving an A1C of 8%.  

I’ve built up a little group of friends who are better educated about diabetes than even some of my Toronto friends now. They sit with me when I’m low, understand that I get grumpy when I’m high and accept me for my idiosyncrasies. They were cheerleaders for me to get an insulin pump and they listen when I talk about my fears. They most likely think my control freak ways were inherited from my parents or picked up from a boss along the way. I wonder if they know that it’s my first complication of diabetes? That diseases often have greater emotional effects than they do physical. I will work on cutting them some slack when they are not perfect and instead endeavour to accept them as perfectly flawed as they are – just like me and my pancreas.

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