As I told you I planned to do, on Tuesday, I headed up to New York City to speak at the young women’s type 1 support group about diabulimia, and diabetes-related food and body issues. I had intended to get up there early because Karen and I were going to meet for lunch, but we got our wires crossed… well, more accurately, her email imploded, but the end result was no lunch with Karen. On the plus side, she promised me that next time I’m in NYC, barring any burning schedule conflicts, she’ll be there to hang with me, so I’m looking forward to that.

It probably worked out for the best though. The night before, I stayed up too late, as I’m inclined to do, and just as I was thinking that I should have gone to bed three hours earlier, my BG started hovering too low. I had some juice. I had some milk. I went upstairs, and the low didn’t feel like it was lifting. I started envisioning myself waking on sopping-wet sheets to Jason, frazzled and fried from trying to lure me out of Lalaland with the ever enticing glucagon injection. I drank a juice box, and topped that off with some glucose tabs, feeling pretty sure I was probably over-treating, but feeling scared shitless I wasn’t.

Five hours and change later, I was up, knowing I needed to get showered and be on my way, but feeling like crap. My BG was high, somewhere between 250-300mg/dL. Too little sleep and too much compensatory sugar made me want to call Katie and tell her I’d be up to share my experience with the support group another time. I got out of bed though, took some insulin, and made some efforts to get myself together. I didn’t actually get out the door until lunch time so lunch with Karen was clearly not in the cards. By the time I got to the train station up in Central Jersey, I was feeling more like myself though, and working with a revised time frame, made some last minute plans to grab coffee with Allison.

Once in New York, I met Allison for an icy beverage and baked goods at Starbucks. She told me about her trip to Oregon and her birthday, and we chatted about various DOC things before she had to get back to work, and I needed to catch the subway to Union Square to meet with Katie. Katie and I also hit Starbucks to catch up on what she’s been up to (which I’m saving for another post) before we headed over to Friedman Diabetes Institute for the support group.

I think the group went pretty well. Public speaking and presenting are a bit of a challenge for me, but it was an intimate group with eight other women there besides me and Katie, so it was a nice, interactive discussion rather than me just lecturing. The group was mixed in that there were women who were familiar with the practice of insulin omission to varying extents, and there was even a woman who wasn’t familiar with it. There were women I’d never met, women I’d met a few times previously having been involved with the group on a couple of past occasions, and even a woman I count as one of my original online diabetes friends.

I told them about my history of depression, diabulimia, bulimia, in-patient treatment, day program treatment, years of regular out-patient therapy, how it started when I was a teenager, how I turned the corner toward recovery. Regarding my recovery, I emphasized the role of understanding my relationship to diabetes, moving from complete denial to total acceptance, and even coming to recognize how diabetes has made my life better. I touched a little on the evolution of my attitude about insulin, from being afraid to take it to making peace with it. We discussed the issues of understanding and normally responding to hunger when you live with a disease that often requires you eat when you’re not hungry and generally interferes with what should be a natural process. We also talked about the problems of finding mental health services that really address the needs of diabetics – the lack of resources available to people when preventative services should be implemented, all the way to the lack of services for people who are drowning in diabetes-related mental health problems, and can’t find a therapist or treatment program that shows a lick of knowledge about how mental health and diabetes are related.

I’m sure I’m leaving out some of the key points that arose. When it comes right down to it, there’s a lot to talk about when it comes to addressing how diabetes affects our relationships to food and our bodies – whether it’s something obviously pathological like a diagnosable eating disorder or something less malevolent, but still problematic, like fighting the urge to binge during a low BG. I can say that I talk about my experience because I hope it will help others feel more comfortable talking about theirs. I know I sound like a broken record, but the medical community isn’t moving fast enough to help the diabetes community deal with mental health issues in all their shapes and varieties, so we have to be the ones to open our mouths or that will never change, and many amongst us will continue to needlessly suffer.

A big thanks to Katie for creating the opportunity to even have a discussion about these issues with the type 1 women of NYC, and also for inviting me to be part of that discussion. I’m also really grateful to the women who were there for attending, listening, and engaging in a discussion about issues that can be difficult to explore, but about which we need to have dialogue if we’re ever going to find ways to help each other and advocate for the services we need and deserve.