Thinking About The Future by Andy Broomhead
To say diabetes is complicated would be an understatement. We all know that, whether we’ve lived with it for 12 days, 12 months or 12 years. Whilst it should become easier to understand and manage with time, it can often present us with a different set of challenges.
I think that people are generally wary of the future because of its inherent uncertainty. We like to know what’s going to happen. Even if it’s something we don’t like or would normally avoid, being able to plan or prepare ourselves for it gives us a certain degree of comfort.
Thinking about a future with diabetes probably introduces more uncertainty than normal. Recently I’ve spent more time than usual considering what my future looks like with my diabetes. That’s quite unusual for me as I tend to rarely give it more than a fleeting thought. It can be quite easy to make yourself worry about things that may never happen.
That said, I’ve been thinking about what could happen ten or 20 years down the line, what that would mean to me and what, if anything, I can do to prevent some of the more unpleasant things associated with diabetes from becoming part of my life.
I’ll take those slightly out of order and talk about what it would mean to me first.
I think my biggest fear with any diabetes complications is a loss of independence which I’m sure many people could relate to. I don’t want to get into a position where I lose some of my freedom to diabetes and have to rely on other people to do things for me. I also worry that diabetes could ultimately take me away from my family much sooner than otherwise. That’s obviously an extreme but something that I’m more conscious of, particularly as I watch my daughter growing up.
So what sort of things could happen that cause these sorts of worries? Well I guess there are a lot of things that could happen but there are a few that I’ve been dwelling on more than others. The first is developing some kind of serious retinopathy. I suspect that our sense of sight is the one we take for granted more than anything, and having that compromised or lost altogether is a very big deal.
I worry about losing my hypo awareness and the consequences of that. Whilst I think we all accept that hypos are an unpleasant and tiring part of the Type 1 diabetes hand that we’ve been dealt, I guess we should be thankful when we can detect them and do something about them before they become serious. Not everyone is in that position and I think to lose that ability to be conscious of what’s happening to my body is really serious. I suspect we’ve all had at least one hypo where our meter reads less than 2mmol and whilst those are hopefully rare occurrences, the alternative where we lose consciousness is one I’d like to avoid if possible.
I also worry about getting neuropathy, particularly painful neuropathy. Approximately 50 per cent of people who have had diabetes for 25 years or more are likely to develop some form of neuropathy. I went through a period where an old running injury caused me some pain on and off for a few years and the thought of being back in that state isn’t a pleasant one.
I think these things are what I focus on because they’re the ones that we face on a more regular basis. We have our eyes screened once a year, have our feet checked for any sensory loss just as frequently, and we check our blood glucose multiple times a day. We’re aware of these sorts of complications and we’re probably more aware of what the first signs might be.
We’re fortunate in a sense because preventing any of these things remain largely within our own hands. Being able to maintain our HbA1c within a target range will reduce the likelihood of us developing complications of any sort and that’s within our power to control, though that doesn’t make it easy! I’ve talked before about how maintaining HbA1c within a recommended range is like walking a tightrope and how keeping your balance can be a lot harder at some times than others.
It’s hard to talk about the complications of diabetes – facing up to our own mortality is never easy. We don’t like to consider the fact that we’re not actually invincible – diabetes or not. But sometimes we need to have those difficult conversations.
The future is uncertain, but it doesn’t have to be scary. It’s natural to think about what diabetes may throw at us in the future but I don’t think we should dwell on it, and we definitely shouldn’t face it alone. Talking about our concerns with our family, friends and healthcare team is important as they’re the people who know us best and can support us.
Don’t be scared to contemplate the future, but don’t allow it to cloud the present either.