Diabetes and Me: 'I can, after all this, live well'

I'm walking down the street when it happens, a cold autumn day in Wellington, deserted because it's the beginning of the Omicron Covid outbreak. I get a notification to my phone: "you have a new health record".

It's my first post-diagnosis HbA1c. The blood test measures how much glucose has been in a person's blood for the past three months. It's the standard test by which type 2 is diagnosed and monitored. I've had two so far, and this is the first one I've had since - in my post pasta life.

I've prepared myself for it to be not much lower. It's only been three months, and I've told myself that I am working really hard, and that's a good start, and as long as it has come down a little, I will be stoked. The result stops me in my tracks. I have to read it three times for it to sink in. I text my bestie and just say "holy shit".

My levels are at pre-diabetes levels. They represent, according to the form, "excellent control". I take a brief moment to bask in the glory of passing a test. While I knew this was possible for many people, I didn't think it would be possible for me.

Those levels have stayed pretty stable all year, although a combination of stress and forgetting to take my medication for an extended period saw them rise fractionally in December. That was a good reminder. But so far, it seems like medication, some diet changes, and all these muscles are working out.

We often equate health with a moral good. And the counterfactual is that if you are in ill-health, it's probably because you did something wrong. The night before RNZ published the first of these columns, I nearly chickened out.

I wanted to write about this experience, because it seemed that something that destigmatised this condition, that helped people to ask questions of their doctors, and said some of the unspoken things out loud might be useful for people. But I also prepared myself for the awfulness.

I assumed I would be told diabetes was my own fault. That being a fat, lazy slob landed me here, and why should anyone have any sympathy for me. And, in fairness, those emailers wouldn't be telling me anything I hadn't already said to myself. After a lifetime of being told that everything bad that has ever happened to me is because of my weight, that's tough to unlearn.

I've spoken to dozens of doctors now, many other people with diabetes, and read probably hundreds of articles and medical papers. Carrying around extra fat was a part of it, but it wasn't all of it, by any measure. And here's how else I know. My diabetes is now, by medical standards, well managed. And I have lost next to no weight. (Here is where I would normally quibble over the difference between weight and fat, but that's a whole different series.)

If you're one of those people who thinks that you can diagnose a fat person by looking at them, my health is entirely different than it was a year ago, but unless you know me well, my body has not changed in the least.

I am not glad I developed diabetes, but I am grateful for the learnings of this year. Finally dealing with a lifetime of being treated badly by doctors, and feeling empowered to say, for example, I don't want to be weighed, has made a massive difference. Understanding why sleep is so important, what protein is, and how stress manifests are all great.

But the biggest difference has been in how I feel about my body. Epiphanies have come thick and fast, about all the ways I have pretended my body was something I could ignore.

About halfway through this year, I bought new sneakers. I went to a store that uses a treadmill to analyse your walk and measure your feet.

"You're a size 9," the salesperson said. "Nah, I'm an 8, I just have wide feet," I replied.

It turns out, I don't. My feet are actually not that wide. It's just that a friend used to tease me about my square fat feet, and so for decades, I've worn the wrong size. I've been punishing myself by cramming my feet into too-small shoes, internalising that shame and turning it on myself. If anything is the reason I now have diabetes, and will be managing it for the rest of my life, that feeling is it. Type 2 is manageable, sometimes reversible. So, I've found, is that shame.

In the end, I didn't get that many awful emails, and I managed to mostly stay away from the Facebook comments and Twitter replies. I got a lot of diet advice, so many suggestions to fast, to go vegan, to only ever eat meat. I got some with advice that seemed deeply concerning - where the behaviour seemed to border on disordered. I am really glad those things work for people. I just wish more people understood that what works for one person won't necessarily work for someone else.

But a lot of people took time out of their day to share their stories, their low carb bread recommendations, and their understanding. They told me I was doing great, and they thanked me for being brave enough to share my story - and that it closely matched their own. I didn't manage to reply to them all, so to those people, thank you in return.

This story began in the gym, so it should end there too. I have chronically tight calf muscles. As I have become more and more active, they are improving, but slowly. Some mornings, I hobble out of bed, and it takes a fair bit of warming up for my legs to move freely. They affect my squat depth, how much I can deadlift, and whether downward dog is comfortable.

But what the gym has taught me is that I can make accommodations for them. My stance can be wider, and I can load my lifts differently. I can do calf raises and foam roll, or I can do different exercises that work muscles in different ways without stressing my calves. And my calves don't indicate a moral failing.

My pancreas is the same. It may always struggle. My genetics and hormones and biochemistry and insulin sensitivity might always combine to mean I can't quite master the balance of energy in and energy out. But I can make accommodations for that. I can take my meds, get my eyes tested and feet checked. I can develop a better relationship with my doctor, and rely on them for advice and empathy, not judgement. I can make different decisions about food, but not beat myself up over not always making the perfect choice.

I can, after all this, live well.