Once, as a freshman in high school, my blood sugar went low in class.
This wasn’t uncommon, but I had my alert set to vibrate the first time it went off and beep the second time if I didn’t open the app, so usually, I would notice the vibration, close the notification, and leave the room to go eat something to bring my sugar up. This time, however, I didn’t notice the vibration, so five minutes later, my low alert went off loudly in class.
Three short beeps.
Before I could get up to go get food, however, I heard a boy behind me say, “It’s a bomb!”
People laughed. The teacher didn’t say anything. I quickly left the room.
Years later, as a senior, I ran into a girl from that class. “Do you remember,” she asked me, “in physical science, when your thingy went off and that guy said, ‘It’s a bomb’?”
“Yeah,” I replied.
“I think about that at least once a week,” she said.
Even now, I’m not sure what she meant. Did she think about it because it was a funny memory for her? Something she could get a mental chuckle out of? Or did she think about it because it was rude and made me embarrassed, and no one did anything?
I have cystic fibrosis-related diabetes. It is very similar to type 1 diabetes, but I got it as a direct result of having cystic fibrosis, a lung disease that also affects my digestive system. I was diagnosed with CF at ten days old, and I was diagnosed with CFRD at age 11. This means I’ve had to deal with having two genetic diseases for seven years. It has never been easy, but I’ve learned to manage it better.
I was homeschooled as a child at the recommendation of my doctors since picking up germs in a public elementary school would have been dangerous and detrimental to my lungs. Hence, I began attending public school when I reached eighth grade. My mother met with the principal beforehand to tell him of my medical necessities, such as needing to keep pancreatic enzymes on me so that I could eat as well as needing to give myself shots of insulin whenever I ingested carbs. The school would not allow me to have either of these things in class with me, so I had to go to the office every time I needed to eat anything. When teachers brought treats to class, sometimes I would miss out on eating them because leaving class would have made me miss part of the lesson. A perk during this time, however, was that if I needed to go eat something for low blood sugar or go take insulin, I could bring a friend with me so that I wasn’t walking the halls alone. Was this necessary? Of course not. Did I do it anyway? Obviously. One of my friends in eighth grade taught me the first (and only) TikTok dance I ever learned while we were in the school office. (It was the “Renegade.”)
In my high school Spanish classes, there were several boys who were frankly very annoying. Not only did they cheat off me during Kahoot games (what even is the point?), but they also liked to make diabetic jokes. We had treats in that class a lot; one such treat was Pan de Muertos, which is a delicious bread topped with sugar that is often eaten on Día de los Muertos. As my teacher served us this bread, one of the boys said, “This is gonna give us all diabetes.”
Now, this is a relatively common joke. It’s not unusual for someone to say, “That’s diabetes in a can” about some sugary drink or even “Diabetes topped with diabetes” when looking at a decadent dessert. You may even have made a version of that joke before. However, for someone with type 1 diabetes, those types of jokes are hurtful.
First, it makes the idea of diabetes, a chronic illness that is very tough to manage and causes innumerable amounts of stress, into something people laugh at. For someone with diabetes, everyday actions spur copious amounts of extra decisions. When eating anything, a diabetic must calculate how much insulin to take, even when there are no nutrition facts available to look at. When drinking soda, coffee, or an energy drink, a diabetic must take into account how the caffeine will affect their blood sugar. When exercising, a diabetic must make sure they have something small to eat with them in case the exercising makes their blood sugar plummet. These are only a few of the extra decisions someone with diabetes has to make, and it all piles up a lot of stress and decision fatigue. When someone quips, “Oh no, I’m gonna get diabetes,” making it sound like a funny thing that wouldn’t be a devastating diagnosis, it is offensive and thoughtless. Secondly, saying such things implies that having diabetes is a direct result of personal choices. For someone with type 1 diabetes, this is false. Diabetes does not stem from “eating too much sugar.” It often originates from genetics or pancreatic diseases, two things that are not at all in people’s control. Even type 2 diabetes, which can in part be caused by obesity or lack of exercise, has components from genetics or family history, which are again out of anyone’s control. Saying, “This cake is going to give me diabetes,” makes it clear you are ignorant about diabetes and its causes, and it makes anyone with diabetes feel bad about their condition. When in doubt, don’t joke about a serious medical illness.
In my freshman and sophomore years of high school, I had a wonderful teacher who was diabetic. She was one of the sweetest people I have ever met, and she loved to provide our class with breakfast occasionally. She would bring in her griddle from home and make us pancakes, and she always brought sugar-free syrup. While I am perfectly capable of eating regular syrup (I do often prefer the sugar-free kind, though), my teacher usually ate sugar-free versions of things. The moral of this story is that when you meet someone who is diabetic, it is good to ask if they need or want sugar-free options, but you shouldn’t assume that a diabetic is unable to eat sugar. The fact is that most people with diabetes are still able to eat sugar normally as long as they take enough insulin. Some cannot or would prefer not to; however, you shouldn’t make assumptions.
Additionally, throughout high school, I ran cross country and track. As an individual with two genetic diseases that severely impact one’s ability to run, it was very difficult when I was starting out. Over time, I learned how to manage my blood sugars while running, and my lungs got stronger from all the physical training. I would always fill a tiny Ziploc with jellybeans or Skittles to eat if my blood sugar went low on runs, and if it did, my team would stop and stay with me while I ate them. Once, however, I was running a workout with my team and our coach. My blood sugar went low during this workout, and when I mentioned this, my coach asked me if I could just eat my candy while running because our heart rates would drop a little if we stopped. I begrudgingly agreed because I didn’t want to be a detriment to the workout for the rest of the team, and I tried to swallow down my Skittles while running without choking. I finished the workout completely exhausted; my blood sugar was still low because I hadn’t stopped exercising to let it come back up. Low blood sugar causes fatigue, shakiness, and muscle weakness for me, so I was drained far beyond the usual workout exhaustion. My team waited for me to eat something else before we started our cool-down mile.
When you are with a diabetic, whether in an athletic setting or not, it is important to ask them what they need. Low blood sugars are dangerous; they can lead to unconsciousness or seizures in severe cases. High blood sugar can also be dangerous if it gets too high; it can lead to ketoacidosis or other complications. When a diabetic has low or high blood sugar during an activity, stop the activity and ask what they need to do or if they need you to get them anything. Medical problems are much more important than immediately continuing an activity or having your heart rate drop a little below target range during a workout.
To clarify, most people in my life have been very kind and accepting of my diabetes and the necessities that come with it. And people who assume I can’t eat sugar or don’t know whether I need to take insulin when my blood sugar is high or low (the answer is when it’s high) aren’t being rude. I do not mean to suggest that people who don’t know much about diabetes are disrespectful— rather, the point of this article is to provide more insight into the world of someone who is diabetic and give some advice on dos and don’ts surrounding the subject. (And if you do have diabetes, maybe you can relate to some of this!) To close, I will quote a piece of wisdom from poet and writer Audre Lorde: “It is not our differences that divide us. It is our inability to recognize, accept, and celebrate those differences.”