First of all…what does that question even mean? What does it mean to decentralize diabetes?
In this context, I think of it as deprioritizing diabetes (maybe that’s the better word to use here, but let’s bear with me…let’s stick with decentralize). It’s knocking it down a few pegs rather than keeping it as a permanent fixture at the top of my to-do list.
So I guess this question should be phrased less generally – because of course it’s possible to decentralize diabetes – and more specifically target me, as an individual who is solely responsible for her diabetes care and management…
…is it possible for me to decentralize diabetes from my life?
I’m of two minds when it comes to landing on an answer. On the one hand, I can’t really imagine myself ever being successful at decentralizing diabetes. I’m always thinking about it. Every decision I make, consciously or subconsciously, is made knowing that it will have implications (in some way or another) on my diabetes. Even when I’m asleep, I can’t escape diabetes because if it’s not directly impacting my slumber by waking me up, then it’s the first thing I think of each day because I do a blood sugar check the moment my eyes are open.
On the other hand…
I’ve been using an Omnipod 5 since late August/early September and although I struggled to adapt to it until recently, it’s since come to represent what feels like a diabetes reprieve. For the first time in my life, I’m thinking of diabetes a teensy-weensy bit less, and I do think that my newfound understanding of the automated insulin delivery system is directly responsible for that. It’s been scary to relinquish control that I’ve maintained for so long over every aspect of my diabetes routine – and hand it over to a piece of technology, to boot – but it’s finally beginning to pay off. Which reiterates the question: Is it really, truly possible for me to decentralize diabetes and let myself be a person first, rather than a diabetic first?
After writing this post and musing further on the subject, I’d comfortably say…it very well could be. With some more time and heaps of patience, I do think I can get to a point where my whole world revolves a little less closely ’round my diabetes.
Hugging the Cactus 
The reason why non-diabetics don’t think about blood sugar management is because a properly working pancreas is fully and perfectly autonomous. Eventually, pumps will become more autonomous and that technology will make living with T1D easier. I have not used the OmniPod 5 but I stopped using Tandem’s Control IQ because it made too much noise and didn’t do as good a job as I do at managing my blood sugars. Why does the Autopilot and full self-driving software in a Tesla vehicle keep improving every month, but the software in insulin pumps never seems to improve? My last technological hope rests with the iLet pump from Beta Bionics. That could make living with T1D much easier when it is approved, especially if it is able to communicate with a watch that is measuring actual blood sugar in real-time. In the meantime, living with T1D is still very much a burden. Years ago, an endocrinologist told me that T1D would be cured (biologically with cells) long before insulin pump and CGM technology got to a point where they were a fully autonomous closed-loop system that did everything for you (and well). I tend to agree with him. It is definitely easier being a T1D today than it was decades ago, but we won’t be free of the burden until new beta cells or islets of Langerhans are ready to be injected into us.
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Agreed, particularly with your comment about the iLet. I heard about it 7-8 years ago and got so excited by the concept. Still looking forward to the day it’s available!
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I would call the term deescalated. Can diabetes be deescalated? Sure when we have perfection. Perfect conditions, perfect carb counting, perfect stress, perfect other health, perfect batteries, perfect 100 other things that impact diabetes. Sure it can be deescalated. Until then? I will take my cue from a famous Indy 500 racer in the 1950’s. When asked if he thought cars were to high tech? It has been reported that AJ Foyt, said if they got any more advanced they would not need drivers. LOL Well they are far more advanced yet they need drivers even more today.
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Hi Molly!
Great question! I do think we’ll always be thinking about it to some degree. At least for a long time. If we’re not thinking about our actual blood sugar management, we’ll be thinking about components of whatever system we’re using to manage and monitoring them to make sure they’re working right. I do think, as you describe, that we’ll find diabetes taking up less and less of our mental and emotional energy as systems get better and better. Here’s to us getting there sooner rather than later! Thanks for raising the point.
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You’re welcome! And couldn’t agree more – the sooner, the better!
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