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When I tell people I have type 1 diabetes, the response tends to be "So you have to inject?" or "So you can't eat sugar?" And I wish it were this simple: avoid sugar, inject insulin and job's a good 'un.

The hardest part about diabetes is not injections or limiting sugar intake. It's not checking my blood sugars on average 10 times a day. It's not being permanently attached to a piece of machinery. It's not changing the sets. It's the constant, never-ending nature of trying to control it.

And I don't even think it's the effort required to control my blood sugars. The hardest part is not looking at the pattern of my blood sugars and adapting my insulin doses accordingly. It's not checking blood sugars and discovering they're too high or too low. The hardest part is never, ever getting away from it.

My diabetes follows me everywhere, and it's on my mind constantly. All day, every day. Even sleep doesn't give me any respite - most of my dreams are related to my diabetes. I worry about what my blood sugars are doing all the time. Even if I've just checked and they're a decent number - I'm wondering if they're on the way up or on the way down. The first thing I think about when I get up in the morning is my blood sugars, and it's the last thing I think about at night. It's on my mind when I make my coffee in the morning - thinking about how things went yesterday and if there's anything I can do today to make it better. It's on my mind in my hour and a half commute. It's on my mind when I arrive at work and hope to God that the post-breakfast spike isn't too high. It's on my mind all morning hoping to avoid a hypo. By lunchtime I have an idea of whether or not I'm having a good day with it. If I've been high I'm wondering whether or not I need a temporary basal; if I've been okay I'm wondering if this will mean an afternoon hypo. On my way home from work I'm dissecting the day to figure out why my blood sugars were high here and why they were low there. When I get home I worry about the effect of dinner on my blood sugars, and every other day I need to change my set and worry about whether or not it's worked. In the evening I make adjustments to my doses and pray that this will help. And it's on my mind as I try to sleep, hoping that I won't have a hypo unawares. It's on my mind all the friggin' time.

It's this 24/7 nature of diabetes that bothers me the most.

But I guess I'm never bored!

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