A Pre-Existing Condition

by kerri morrone sparling

With pre-pregnancy planning in full gear, I’ve been reading more and more about the specifics of what those nine months will hold. It’s weird to think that diabetes, something that many pregnant women are constantly warned against developing, is already part of my pregnancy equation. I won’t be doing any glucose tolerance tests once I am pregnant because we already know I don’t tolerate it well. I won’t be lectured by my doctor – “Listen, we don’t want to have to put you on insulin.” – because I’ve been hooked on the stuff for decades now. Diabetes is already part of my life, and it’s been my reality for over two decades. Done deal.

But for my immediate family, it’s an unanswered, unanswerable query that looms. “Will I get diabetes, too?” It’s the threat of discovery at every doctor’s appointment and it’s the raised eyebrow with every too-frequent trip to the bathroom. As a result of my type 1 diagnosis, our gene pool is now questionable, and this disease is now part of our collective family health history.

I don’t talk about diabetes much to my parents, or my brother and sister, but when approached by the diaTribe team to write something about diabetes and pre-diabetes awareness, there is no better place to start than with my own loved ones. How aware is my family, who has known about diabetes for the better part of my life?

My mother and brother agreed to answer a few questions for me, so I put on my reporter hat (it’s blue and has a pinstriped edging, for the record) and interviewed my own blood about their connection to, and fears about, diabetes.

My brother Darrell, who is six years older than me, wasn’t involved much in my diabetes management but he has the symptoms down pat: “For someone who hasn't been diagnosed, diabetes could fall under many categories associated with other diseases: lack of energy, sluggishness, weight loss. The key ones that stick with me are watching for an increase in urination and a greater intake of water - not being able to process the sugar and watching how the body attempts to flush it out is the red flag for me.”

With my diagnosis, diabetes was a mystery disease. My bed-wetting at the age of six and chronic infections weren’t red flags because my parents had no clue what diabetes really was in the first place. But for my brother, who has two small children and now a family history of diabetes, a soaked diaper or a rash that won’t heal is immediate cause for concern.

“Does your family doctor know about our family history?” I asked. “Are your son and daughter under close watch for these symptoms?”

‘It's one of the first things we bring up, so they have it on their radar and won't let little things go that they would otherwise put off or ignore. As an adult, I'm screened on every physical and our children are checked on their scheduled visits as well.”

And then an added: “So there.”

My brother and I have an easy banter about diabetes. It’s something we didn’t talk about growing up, but with my diabetes blog read by family, friends, and strangers alike, there’s a growing comfort and a grown-up understanding about it now. We both know it’s serious, it’s important, but it’s still me in this mess, so we find the most human parts of this condition.

My mother, however, has had a very intimate understanding of diabetes for many, many years. She wasn’t watching from the sidelines but instead my first line of defense against diabetes, even when I was just a kid. I asked her a few questions about her familiarity with diabetes, and I could imagine the look of “Oh, come on, Kerri” on her face as she answered.

“Mom, do you know the symptoms of diabetes?”

“Kerri.”

“Mom, seriously. This is for an article. Humor me.”

“Yes, I know the symptoms very well.”

“And did you and Courtney [my younger sister] get tested for the antibodies at Joslin, way back in the day?”

“Courtney and I were tested to see if we had the antibodies at Joslin. Our tests were negative. The reasons I would want to know the outcome was to hopefully prevent ketoacidosis and start insulin therapy as soon as possible. It could keep the child in a honeymoon period longer.”

I thought it was amazing that my mother, already reeling from the diagnosis of her oldest daughter, went to find out if her other children were at risk as well. Some people fear the unknown, and this could be a reason why people avoid asking for these tests at the doctor’s office. There are millions of people in the United States alone who are living with diabetes and don’t even know it – and there are even more who have diabetes but don’t know how to treat it. For my mother to seek out answers to questions she didn’t want to ask, I find that to be very brave indeed.

But if I wasn’t diabetic, would my family be so educated? My friends and my extended families are hyper-aware of diabetes as a result of my life with it, but how would they know what to look for if it weren’t for my diagnosis? What kind of public health crusade must take place in order for people to be brave enough to find out the truth about their own health?

My mother lets her doctor know about my diabetes and she is tested at every visit for any fluctuations in her thankfully non-diabetic A1C levels. But my mother knows this disease from angles I can barely understand. She knows what it’s like to worry incessantly about things that cannot be controlled, and how to look at her child and feel unsure of their health in the future. Now that it is part of our family and our lives, the worry that her other children, and her grandchildren, will be affected is a real concern. My mom educates. She advocates. She wants people to be keenly aware of how diabetes can affect a life.

“Parents are responsible for the well-being of their children from birth to when they are able to live on their own. Not that it stops us from worrying. We never stop worrying. Throw diabetes into the mix and it can be overwhelming at times.”

And as I sit here, planning my own future family and working hard to mitigate potential risks and plant seeds of hope for our success, I am beginning to understand how she feels.