We were all of 14 when my friend from school, Palak Malviya, called out to me in our classroom and said, “Pande, cover me.” She then proceeded to remove a long, steel rectangular case from her backpack and pulled out a syringe, a sealed glass vial and some alcohol wipes.
As I stared, she prepped the syringe with the correct dosage, lifted her school uniform’s skirt to expose a rather bruised thigh, and looked up at me.
I lifted my skirt from the sides to give her cover and watched as she expertly injected herself.
“Diabetes, type-1,” she said matter-of-factly, “and the things it makes you do.”
I nodded quietly, understanding that it was an insulin shot, and letting the reality sink in.
When most kids at that age worry about the approaching boards, puberty, and crushes, Palak had to do what she could to keep her sugar levels under control, to stay alive.
Years later, in April 2023, I was away for the weekend with a new set of friends. I noticed that one of my new friends, Anushka, 25, was not eating anything.
“Padma, I have type 1 Diabetes,” she confided in me. “I can’t eat most of the stuff here.”
As I took that in, she took out a funky-looking insulin pen and injected herself in front of everyone on her stomach.
I noticed the difference between both of these scenarios immediately. While one asked for cover then, the other was pretty nonchalant about it. But throughout both these scenes, what remained common was my own feeling of helplessness.
I wanted to do something for my friends but I didn’t know what was the correct way to give them the help that would benefit them. To not feel this way again, I asked experts how to provide the right kind of care for our friends living with Diabetes.
What Everyday Looks Like for Diabetics
With diabetes, your body does not produce insulin on its own, so you have to take it from an external source and keep a regular check on your sugar levels throughout the day, shares Anushka.
According to the United States' Centre for Disease Control and Prevention (CDC), this is how your fasting blood sugar level corresponds to your condition:
Normal: 99 mg/dL or lower
Pre-Diabetic: 100 to 125 mg/dL
Diabetic: 126 mg/dL or higher
“It does affect my day to day for sure and it's difficult to not wonder what it would be like to have a functioning pancreas at times, but this thought passes away rather quickly,” says Anushka.
Palak, now 28 years old, concurs. She says, “My days begin with checking my blood glucose level, and that set the tone for the day. I inject my bolus insulin before my meals and the dosage is adjusted to the carbohydrate intake. So, there is a lot of math that goes behind what I decide to eat.”
For Palak, her glucose levels don't just dictate what she can eat, but also her emotions throughout the day. She tells FIT,
"As I navigate through my day, my blood glucose levels affect my mood, emotions, and energy so I need to be mindful with respect to my work, routine, as well as interactions with people around me (for example, high blood glucose levels make me moody and irritable, so I try to avoid serious conversations)."
Since glucose is the primary source of energy for our bodies, the lack of it can be life threatening.
Dr Unnikrishnan AG, endocrinologist at Pune's Chellaram Diabetes Institute, explains, “When it comes to diabetes, one thing that must not be forgotten is that it is a chronic illness – this means a lifelong commitment to good diabetes care.”
Considered an invisible disability in the West, Dr Unnikrishnan emphasises on how patients often require encouragement and support from friends and family members to seek appropriate healthcare for diabetes.
“The struggles I face are invisible, and are far beyond the injections I take, or the times I prick my finger for a blood test,” Palak shares.
What Is The One Thing You Would Want Your Friends, Colleagues To Know About Your Diabetes?
Nupur Lalvani, Founder, Blue Circle Diabetes Foundation, who has been living with type-1 Diabetes for 28 years now, shares that help is interpersonal and dependent on what is comfortably shared with you by the patient.
But, “you can’t be a friend and still be indifferent,” she points out.
Anushka wants to address how diabetes is not curable as of now. Palak wants people to know that type-1 diabetes is different from type-2, it is autoimmune and incurable, and not caused by "eating too much sugar."
She also wants people to know that there's only so much she can do to control it.
“Yes, diet and exercise take you far, but there are tons of factors that affect blood glucose levels like stress, sleep, and even temperature and altitude. This is also why I need people around me to accommodate my needs while I socialise, like eating on time,” she added.
Dr Unnikrishnan nods in agreement. A caregivers' role is of paramount importance, he asserts.
“Make sure they eat healthy and get time and avenues to exercise and be physically active. A spouse, or other family members, could take on daily chores to allow the patient with diabetes to exercise in the mornings,” he adds.
How Can We Help You Live Your Life Better?
Both Palak and Nupur stress on how important it is to ask questions rather than assuming what type-1 diabetes and life with it is like.
There are some other things you can do as well:
Lend an understanding ear when a type-1 diabetes patient wants you to make some accommodations in a plan, especially when it comes to adjusting the meal timing
Read up or join online forums for more information or discussions
Remember that the patient’s glucose levels aren’t in their control a lot of times
“I’d request everyone who knows someone with diabetes to be mindful, and to have patience because of this fluctuation. Various factors could be affecting these levels and putting us into a hypo or hyperglycaemic state which can be difficult to cope with. A little help and kindness goes a long way with us."Anushka, 25
Allow your friends the space to confide in and discuss their condition with you and ensure that they are not alone in this
Living With Diabetes
For Anushka, this is her “normal”. After living with this condition for 17 years, she, like Nupur, doesn’t know anything different.
“My diabetes affects not only me but the people around me as well, which is what I dislike the most – the worry it causes to my beloved,” Anushka adds.
In Palak’s case, life after the diagnosis at age 10 was rocky, to say the least. Her parents and she struggled with it mentally and emotionally for a long time before they went to a diabetes camp, which changed things for the better for her.
“There are days where it still hits me deeply. It’s a process.”Palak, 28