We thank you for your many queries related to life with diabetes! And many thanks to our host Wil Dubois — diabetes author, community educator and veteran type 1 himself — for diving deep into such a variety of D-related topics.

This week at Ask D'Mine he's taking on some fundamentals: dealing with mega-unhelpful family members and mega-challenging workplace issues.

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


Renee from New Jersey, type 1, writes: When I went home to visit recently, my mom actually asked me to test and take my injections in the bathroom, in order "not to upset people" in my family. This made ME really upset! Why should I have to hide? How un-supportive can a family get?

Wil@Ask D'Mine answers: My wife and I have talked it over, and we've decided to adopt you. Of course, we'll have to stand in line with the other 940,000 adult type 1s in the country who'll also want to adopt you once they read this column.

So, your email made ME really upset, too! Well more than upset. Upset would be an understatement. It pissed me off, big time. I got mad. Really mad. This is one of the most degrading, detestable, despicable, contemptible, loathsome, reprehensible, vile, awful, revolting, foul, horrible, callous things I've ever heard of! And from your own mother, no less!

You should not have to hide.

At home or any frickin' other place, for that matter.

Not then. Not now. Not ever.

You have the fundamental human right to be you, and to do what needs to be done to keep yourself healthy. You deserve the active understanding and support of your family; not to be treated as a metaphorical leper.

I believe your family has reached a new low in unsupportiveness. In fact, I think we should give them an award. You, know, in the spirit of the Razzies, the Ig® Nobel Prizes, or the Darwin Awards. Readers can help us choose the name for this award to recognize new lows in diabetes support.

But meanwhile, what to do about your mom? I don't think you can just let sleeping dogs lie in this case. I think you need to call her on it, in some way. Diabetes is part of who you are. Your family, most especially your mother, needs to accept it as part-and-parcel of Renee.

Frankly, if I were in your shoes, I'd now go out of my way to test and shoot up in front of them. Wear them down from constant exposure and constant reminder. Refuse to retreat to the bathroom. I'd even go further than that, oh, here, will you hold this vial for me while I shoot my insulin?

I bet that's what Gandhi would have done, if he'd been type 1, and his mom had treated him that way.


Randy from Rhode Island, type 1 writes: I have a high-stress job and work the night shift. I have other medical problems that I have been able to manage; but diabetes is a very complex disease where diet, rest, exercise and medications are a continuing balancing act. I'm not sure if there is anything I can do other than find a day job, but do you happen to have any ideas or information about diabetes management and working night shift?

Wil@Ask D'Mine answers: If you find a day job you'll find that diabetes is still a very complex disease where diet, rest, exercise, and medications are a continuing balancing act. It really doesn't matter if you are trying to do it by moonlight or sunlight.

One thing I don't know is whether you're using an insulin pump. If not, that's the single best thing you could do to balance the demands of your life. Pumps allow for much, much, much, much, much, much more flexibility when dealing with a chaotic life. Take basal insulin, for instance. For our type 2s who take pills, let me briefly review this topic: All type 1s (and some folks who've had T2 for a while) need two kinds of insulin coverage, called basal and bolus. Bolus is a fast, strong insulin you take when you eat, or when you need to fix an oops! blood sugar. Basal on the other hand, is a slow, low-grade insulin that helps the body process the constant drip-drip-drip of sugar from the liver that keeps your cells fed between meals and while you sleep.

Basal insulin needs, for those of us pancreatically challenged, have traditionally been addressed by taking injections of a time-release insulin. This actually works fine for some people, but not so well for folks with highly variable stress. Pumps dispense with the need for this kind of basal insulin by dripping a constant supply of the fast-acting insulin into your body from the pump, to cover your body's basal needs (of course the pump can also deliver a bolus for meals or corrections).

The advantage is that you can easily vary the supply as your needs change. First, you create a basal pattern where you and your medical team choose how much basal drip, called a rate, you'll get at various times of the day, based on your patterns of eating, exercising, stress and blood sugars. But you can override these and deliver more insulin to counteract elevated blood sugar from increased stress; or less insulin to compensate for lower blood sugar from increased activity. The real beauty of this system is that, because it uses fasting-acting insulin, the changes you are making only effect a relatively short window of time.

By comparison, you can't "take away" a time-release basal insulin shot after you've taken it. If you need less, your only solution is to eat extra carbs to soak it up, and that makes you fat! Also, if you need more basal insulin and you're using an old-fashioned shot, you're committing to more insulin for a full 24 hours, which often leads us back to the start of this paragraph.

So rather than get a day job, I'd get a pump. After all, your diabetes therapy should be made to fit your lifestyle; your lifestyle shouldn't have to change to fit your diabetes therapy. That's putting the cart before the horse.

But for what it's worth, I also called around to some other night workers to see how they were handling their diabetes. Edward Cullen, Nick Knight, Barnabas Collins, and Lestat de Lioncourt all tell me they use insulin pumps to manage their diabetes, crazy night shifts, and stress.

What? You didn't know that most vampires have type 1 diabetes?

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.