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managing diabetes is a 24/7 balancing act to keep blood sugar levels in check

tech makes the job easier, but it still eats up time and major mental bandwidth

by wendy haaf, postmedia content works

published nov 06, 2024

last updated nov 14, 2024

4 minute read

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4 minute read

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diabetes is a 24/7 balancing act to keep blood sugar levels in check

“i’m anxious about my kidney function every time i get bloodwork,” says kimberley summers, referring to the mental health impacts of living with type 1 diabetes. paul daly

this story was created by content works, postmedia’s commercial content division, on behalf of a client.

in addition to a demanding government job and co-managing a household, kimberley summers of st. john’s, nl has a time-consuming side hustle. diagnosed with type 1 (t1d) diabetes at age two, the 53-year-old spends untold hours every month managing the condition to maximize her chances of avoiding more life-altering complications than she has already endured. “i’ve got 50 years under my belt with this thing, and sometimes i think i’m doing pretty good,” she says. while even the busiest among us squeeze in some downtime, for the estimated 300,000 canadians with t1d, the effort required to stay alive and as healthy as possible is itself a 24/7 job. in t1d, the body’s infection-fighting system destroys cells that produce insulin. this hormone is crucial for carrying sugar from the blood into cells that use it for energy. without insulin, various body systems shut down, and a person can’t survive for more than a few weeks.

while the advent of injectable insulin treatment has saved countless millions from this fate, for people with t1d, managing blood sugar levels remains a complicated, mentally taxing task. and even when well-managed, over time, t1d can lead to a long list of complications stemming from blood vessel damage. for example, t1d raises the risk of experiencing heart attacks and related events as much as tenfold.

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summers explains it this way. “you kind of age before your time. i’m 53, but my blood vessels are probably similar to someone who is in their 70s.”

at one time, summers had to prick her finger to check her blood sugar levels at least three times daily and inject herself with insulin before eating anything containing carbohydrates (which break down into sugar). while today, she is fortunate enough to have access to wearable devices that simplify those processes somewhat, the time commitment and mental workload are still considerable.

for instance, even with a continuous glucose monitor (cgm) and insulin pump, every time summers eats anything, she must calculate the grams of carbohydrates the food contains and adjust her insulin dosage accordingly. and that can be difficult.

say you’re served potato as a dinner guest. since you can’t weigh it, “you’re going to eyeball it, and the more you have to estimate things, the more chances you’ll foul it up,” summers explains, leading to blood sugar levels that are either too high or too low.

similar fluctuations can happen even when your math is perfect. factors like viral infections, trauma, surgery and stress can all cause blood sugar levels to skyrocket. toughened skin due to repeated jabs can interfere with insulin absorption — and therefore, blood sugar regulation — too.

last spring, for example, summers experienced a spate of unexplained high readings. “i tried everything — i was meeting with my diabetes nurse educator and my specialist more often trying to figure things out,” she recalls.

and that’s just one way high and low readings eat into someone’s schedule. a low blood sugar reading first thing in the morning — which isn’t uncommon — is a potentially dangerous event that causes extreme fatigue and brain fog. “you can’t function, and it’s hard to get out the door,” summers says. consuming fast-acting carbohydrates, such as juice or sugar, corrects the problem but takes 15 to 45 minutes to work.

bloodwork appointments and meetings with multiple medical professionals also consume enormous amounts of time and mental bandwidth. summers regularly sees a family physician, cardiologist, endocrinologist, foot specialist and ophthalmologist. she also missed a year of work after a 2020 surgery to amputate the toes of one foot because the wound stubbornly refused to heal.

all this takes an emotional toll, too. during every difficult blood draw, summers worries she’s developing the bone-like vessels that contributed to her father’s premature death due to complications of t1d. “i’m anxious about my kidney function every time i get bloodwork,” summers says.

similarly, every minor memory lapse leaves her wondering whether she’s developing vascular dementia. unsurprisingly, a first of its kind national study conducted by diabetes canada found that 46 per cent of people living with t1d have experienced distress related to the many challenges of the condition.

managing a long-term condition can also contribute to feelings of anxiety, with people who have diabetes being 20 per cent more likely to experience feelings of worry and fear than the general public. depression — which summers has also struggled with — is up to three times more common in people living with diabetes than among those without diabetes.

summers feels grateful for the support of her husband and son, and for medical advances that have helped better manage her condition. yet even with her husband’s insurance covering 80 percent of the cost of sensors, she pays $50 per three-pack.

“my employer doesn’t cover cgm, which is the best technology out there,” summers says. she would like to see governments provide access to these devices for all canadians with t1d. “that would not only benefit the person, helping them lead a longer, better quality life,” she says, “it would help society by reducing strain on health care.”

this diabetes awareness month let’s make time to recognize the mental load of managing this often-overwhelming condition by visiting diabetes.ca/letsmaketime.

this story was created by content works, postmedia’s commercial content division, on behalf of diabetes canada.