My Diabetes Inklings

A Conversation with Another Healthcare Professional

“Isn’t it great that the government is subsidising this tech (referring to CGM)?”

“Yeah it’s only for people with type 1 though”

“People with type 2 shouldn’t get it. They don’t look after themselves.”

That was my conversation with the pathology nurse last week at my pregnancy appointment. I was shocked, upset, defensive and angry all at once and didn’t know which emotion to act upon. I think a bunch of garbled gibberish left my mouth and the nurse picked up on my discomfort. They took it as an invite to justify their comment saying that people with type 2 diabetes don’t do themselves any favours.

Firstly, no one asks to be diagnosed with any sort of chronic health condition. Secondly, as healthcare professionals, it’s not our place to place judgment on a person. We are there to help people get better. First we must do no harm. Yet, by making assumptions and furthering the stigma around conditions like type 2 diabetes, we are causing harm. Not only that, we are signalling to the general public that it is acceptable to shame people based on their healthcare needs.

As a result, people with type 2 diabetes feel guilty and ashamed and are less likely to reach out for help. Especially if they are unlucky enough to have one these people as part of their healthcare team. Imagine going into your consult, only to be lectured and berated like a child because your body isn’t coping and you feel overwhelmed with how to turn things around.

“Oh but you have type 1 diabetes and that’s different. You didn’t cause your diabetes.”

Type 2 diabetes has a strong genetic predisposition. Lifestyle factors may be the trigger in some cases and yes, type 2 diabetes may be reversible for a select minority, but every body and circumstance is different. In healthcare, there is never a one size fits all approach. What good comes out of a dividing a community that can do more by banding together to raise our voices?

All we want is affordable and accessible tools and strategies to help us manage our diabetes; a condition that is 24/7 involving about 180 decisions a day. We need individualised approaches to tackle diabetes so we can live our best lives. There is no room for judgement, stigma or shame from anyone, let alone the healthcare professionals who are supposed to be supporting us.

Looking back, I wished I had taken a stronger stance with the nurse and called them out for perpetuating the stigma around diabetes. Perhaps they weren’t aware of the implications of those words, but I have been around long enough to know the lasting impact they can do to a person with diabetes. And maybe that’s the conversation we needed to have so they become aware too.

My Diabetes Inklings

In my perfect world…

Moving to a new area, it took me a while to get a referral to see a new psychologist as I’ve been struggling with my mental health while adjusting to life as a working mum. After about two months, I finally had my initial appointment, to which I was more than half an hour late for (that’s a whole other story for another time). One of the exercises the psychologist recommended to work through was to reflect on what my perfect world would look like if I woke up the next day and all my stressors disappeared.

Initially I laughed and joked that not having to worry about money would definitely resolve my issues. You know, as you do. Then I started thinking deeper about other things I wanted from life. I listed things like having the flexibility to work on projects that inspire me, being able to spend more time with my family. Selfishly, I wanted to spend more time doing things I love like boxing, playing music, learning to cook and reading – things I used to do before I started working in academia. These days every spare moment in my day is filled by teaching commitments and pursing the next grant or publication. There’s never an “off button” and it’s exhausting because when you’re not doing it, you feel guilty for it. Even though you’re already putting in more than your contracted hours.

What struck me as interesting was that never once did I say that I wished I didn’t have diabetes. Living with diabetes, and its (literal) highs and lows, is something I’ve seem to have accepted as a constant in my life. If anything, its presence reminds me that of everything that is happening around me in life, I am the most important thing. Diabetes reminds me that self-care is not just a cliche but a necessity.

Perhaps this exercise was indeed worthwhile to remind to work harder on maintaining this balancing act called life. More importantly, it’s made me reflect on what living my life might mean and what that could look like. Of course, it will never be the perfect picture that I have idealised and that’s not what I would like either. Having some discomfort in our lives will push and challenge us to improve ourselves and situations. That being said we shouldn’t be constantly feeling overwhelmed, emotional, anxious and on the brink of exhaustion.

I’m looking forward to working with my psychologist over the next few sessions to workshop some strategies to get that clarity back and feel like I’m back on track. I’m tired of feeling exhausted and stuck (literally and figuratively). I’m excited to feel that flicker of hope of feeling back in control.

Balance is ever changing. Being comfortable with that flexibility is also something I’m trying to work towards. Especially with our world about to get a little more crazy!
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One Step Closer

Over the weekend we heard announcements from both major political parties in Australia promising CGM subsidy for people with type 1 diabetes should they win the upcoming election. For us, this would mean paying $32.50 per month for CGM as opposed to $330 for life saving/changing technology. In real terms, it means being able to have further options when it comes to diabetes management.

The ability to see what my glucose levels are doing in real time provides such a huge safety net, especially being pregnant and chasing after a toddler, while trying to juggle full time work and life in general. For some it means freedom and independence to live their lives rather than being in fear of a high or a low and its repercussions. Regardless, having it within our reach is a pretty effing big deal.

I had expected to be equally effing excited and happy to hear such an announcement. Instead I felt surprisingly dirty and angry. Angry that our healthcare needs were being used as a political game piece; that politicians were trying to buy our vote with promises that might not necessarily eventuate. Although to be fair the last time they promised CGM funding to those with clinical needs, they actually delivered. So I do have hope.

I’m also upset at myself for taking on such a cynical view. Especially knowing how hard organisations and individuals have worked and advocated for this over the last decade. These changes are not something that happens overnight and I’m so so proud and happy that their hard work and our persistence as a community to advocate for this has paid off. I just really really hope that regardless of the outcome, these promises will become reality.

But the advocacy doesn’t and shouldn’t stop there. Diabetes doesn’t fit into neat little tick boxes that our healthcare system has adopted. There are so many people living with different types of diabetes or similar conditions who would benefit from ongoing CGM use. As a community, we need to continue advocating for everyone within the community to keep #CGMforALL a reality. Our voices are stronger together and I really hope that the advocacy doesn’t slow down once people with type 1 diabetes have access to CGM subsidy. I mean, we’re still fighting for insulin pump consumable subsidies to be accessible for people with type 2 diabetes too.

So here’s to the freaking Easter bunny. For giving us a luxuriously long weekend, with fabulous weather, news to celebrate and reflections to mull over.