Welcome back to Ask D'Mine — our weekly column proudly going where no diabetes Q&A has gone before.

If you happen to fear complications, OR be a man with this stupid disease, you will not want to miss this week's edition, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

{Need help navigating life with diabetes? Email us at AskDMine@diabetesmine.com}





Leticia from Uruguay, type 1, writes: I'm 27 and I've been a type 1 diabetic for 18 years now. I have never been able to reach appropriate Hemoglobin A1c levels, although I've struggled to do so. How long will it take for long-term complications to appear?

I'm sorry if I miss-wrote any word, but I'm a little out of practice in writing in English.

Wil@Ask D'Mine answers: As it turns out, that's a complicated question, (pardon the pun), but I do know the answer. However, before I tell you, I want to qualify it—because it depends.

It depends on how "inappropriate" your A1C is. The more inappropriate it is, the more quickly you could develop complications.

It depends on how much of that inappropriate A1C is fueled by always being very high vs. an average of being very, very high and being lower. Rocky-high blood sugars cause more damage, more quickly, than stable-high blood sugars.

It depends on your age at diagnosis. Diabetes is more aggressive in younger folks. Being dx'd younger, rather than older, causes more damage. You were nine when you got yours, I see.

It also depends on your genes. And, to some degree, luck.

Oh, and it probably depends on whether the moon is in Leo or Cancer and whether the wind is blowing from the west or northwest, and whether the barometric pressure is rising or falling... In short, you mileage may vary.

I'm sure you already don't like were this is going, but now I need you to sit down; you're really going to hate my answer.

Because the answer is five years.

Odds are, my young friend, you're already a little bit complicated. But don't freak out on me. I'm not done yet.

Now, when a type 2 is diagnosed with diabetes we give 'em a meter, a T-shirt, some meds, and a referral for a dilated eye exam.

When a type 1 is diagnosed we give 'em a meter, a T-shirt (or Teddy Bear, depending their age), some meds, and a valium prescription for the mom and dad.

You'll notice that a brand-new T1 doesn't get the referral for the eye exam. Why?

Because the blood sugar hasn't been high enough for long enough to have caused any trouble. Not yet. We also don't test microalbumin in the first five years after diagnosis of a type 1. No need. It's a waste of pee (and more importantly, a waste of a Clinitek strip, which are expensive little bastards). Again, the sugar hasn't been high enough for long enough to cause any damage to the kidneys.

But the type 2 gets sent straight to the eye doc (after peeing in a cup, of course). Why?

Because by the time most type 2s get diagnosed, they've been diabetic for years already. The actual process begins 12 years before diagnosis, on average. Type 1 comes on like a typhoon. Type 2 comes on like global warming. By the time a T2 gets the bad news, a lot of damage has often already occurred.

And it turns out that five years is the magic number. Five years of high blood sugar will begin to damage your body. Begin. It's a slow process. A steady process. A process that can be stopped cold at any point. A process that in some cases, can even be reversed to some degree.

So being a little bit complicated is par for the course. That doesn't mean you are disabled. It doesn't mean your fate is sealed. But, for you, Leticia, I think your warranty has just expired. You've had high blood sugars for 13 years beyond the complication zone. Your genes are good, your stars are clearly aligned in the heavens, the wind is at your back and you've been damn lucky. You are still free of major complications. I want you to renew your struggle to get your A1C to an appropriate place, starting today.

And, Leticia, no worries on the English. You did just fine. Diabetes is a Universal Language!


John from California, type 1, asks: Like you, I am a type 1, on a pump and CGM and I'm a guy.  When you go out, where do you put all the "stuff?"  We need to carry pump, CGM monitor (if not integrated), meter, strips, lancet and glucose, at a minimum.  Do you carry a "man purse," or perhaps wear some of those big New Mexico cargo pants?

Wil@Ask D'Mine answers: My gear for a typical day includes my pump, my CGM monitor, a meter with lance and strips, a medic alert bracelet, glucose fluid, glucagon, spare triple-A batteries, a blood ketone meter and strips, a backup fingerstick meter and strips, a spare infusion set and reservoir, back up insulin, and a flask of whiskey... you know... just in case.

And that's just for the diabetes. Modern life also requires a cell phone. And I still use an old-fashioned PDA to keep organized because my phone is an old-fashioned dumb phone. And car keys. And a driver's license. And insurance cards. And money (yeah, right). And a wrist watch. Oh, and I think having some Listerine Pocket Packs on hand is always a good idea too. You never know when a pretty girl might kiss you.

That's a lot of crap to carry.

It's true that I've been known to wear cargo pants. And they work great, but the problem with cargo pants is they aren't proper attire when you go to the Opera. Or when you need to apply for a job. Or a bank loan. Or when you are summoned to testify before Congress (hey, it could happen). The other problem with cargo pants is that you have to fill all the pockets every morning when you get dressed.

But the solution to this quandary is most definitely not a man purse. No way. Let's be very clear about this, I'm waaaaay too macho and manly and studly to carry a man purse. Carrying a man purse would hurt my image as a chic-magnet.

Instead, I carry a "go-bag."

Over the years, my go-bags have varied, but generally start their lives off as camera bags. I find the "messenger" style works best for me. Partly because camera bags are more, you know, manly, than man purses; and partly because they have lots of little compartments for all our little things we need to have on hand.


Who am I kidding?

It's a man purse.

As to what goes in the go-bag and what goes on the body, currently, and for most of this year, I've been wearing my pump and my CGM side-by-side on my belt, on my left hip. On the right side I have, again, from the world of photography, a very small CaseLogic camera pouch that holds my Presto with a OneTouch lancing device securely velcroed on to it for one-handed use, and a vial of strips. Some days I feel a little like the Storm Troopers from Star Wars with the utility belts, but most days it doesn't bother me, and no one seems to notice.

Everything else goes in the go-bag. The bag hangs on a hook by the front door when I'm at home. If I leave the house, the go-bag goes with me. If I'm out and about the bag may or may not stay in the car. If I'm just popping in to a store, I might just grab a bottle of glucose fluid from the outer pouch of the go-bag and stuff it in my pocket.

Leaving the bag behind entails weighing the risks and benefits. Most of this stuff you can live without for a few hours. Like, say, my dumb phone, for instance.

Now, if I have to look 50% respectable, I'll often ditch the bag and wear a sport coat. Sport coats have enough pockets to handle sugar, meter kit, and cell phone. I still leave the pump and CGM monitor on my waist.

If you happen to live in a cooler climate, Scottevest makes awesome multi-pocket coats and vests that will easily, and sleekly, accommodate your diabetes life support system.

But as I write this it's 102Ëš outside. In the shade. Wearing a vest in this weather would entail not only carrying supplies for my diabetes, but also for the inevitable heat stroke too.




This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.



Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.