Over the years, I’ve talked to a lot of folks with diabetes, and I’ve found that many are angry. Sometimes it’s a specific anger against the high price of insulin or food restrictions imposed by the disease. Other times it’s a widespread frustration over the general demands of diabetes -- a chronic condition that requires your attention a great deal of the time.
I would often try to reassure these people. I told them that taking care of diabetes wasn’t really that difficult. The keys were persistence and consistency -- to lose weight, to exercise, to take their medications. To pay attention to their A1c readings and to talk to their doctors honestly about their concerns.
I told them that I had done it for 30 years without serious complications and so could they.
I do still believe that.
But as we endure this terrible pandemic -- where many people with diabetes are essential workers -- taking care of the disease has grown harder. Ironically, this comes at a time when it’s vitally important for people with diabetes to stay healthy, since having diabetes is one of the top risk factors for getting complications from COVID.
How has COVID made diabetes care more difficult? Let me count the ways. For those of us lucky enough to be economically stable and in good health, extra stress from a lack of national health policy to deal with the virus and confused messaging about how to confront the virus has robbed many of sleep and peace of mind. Regular exercise options -- including classes at the Y -- have been shut down. And without the company of family and friends, loneliness and isolation -- both additional stressors that can raise blood sugars -- have increased.
For those who are not economically secure -- including many who have lost jobs or been evicted from their homes or are suffering from food insecurity -- the effects have been more dire. The diabetes mantra to eat well, to exercise, and to keep track of blood sugars can get lost in the swell of other, more urgent concerns. When combined with health care disparities in Black and brown and rural neighborhoods, the complications from diabetes and the virus have led to unacceptably high numbers of deaths.
This is not to say that anyone should abandon attempts at good diabetes care during the pandemic. But maybe -- along with persistence and consistency -- it might be wise to add a little flexibility to your plan. If you can’t eat well every meal, try for two out of three; if you miss exercising the recommended 150 minutes a week, go for as much as you can. Give yourself a break and turn off the news, and take a walk around the block or jump rope for 5 minutes. Avoid screens an hour before bed, and try to get a little more sleep.
As I shelter at home, my casual conversations with strangers have become less frequent. But if I were to run into any of the people I once talked with, I’d like to tell them that I get it.
I’m angry, too.