What Is a Cure for Diabetes?
by kerri morrone sparling
What is a cure for diabetes? Is there room for variances in that definition?
I had just started second grade when I was diagnosed, and I believed my doctors when they talked about “a cure in five years.” No more shots, no more measuring food at every meal, no more catching my mom’s brow furrowed in worry throughout the day. Five more years. It was a number I held in my pocket and hoped would bring me better health. I figured I’d be cured by high school.
But the promise of that “five years” has come and gone almost five times over now, having marked my twenty-fourth year with type 1 diabetes this past September. Nothing shocked me more than walking across the stage as I graduated high school, knowing I was still diabetic. I know it seems crazy to put such stock in arbitrary time frames, but I couldn’t help it. Since I was a kid, my vision of a cure was always the same – no more diabetes. Period. Without understanding how life worked (never mind diabetes), a cure was something that would reverse my autoimmunity and allow my body to make insulin again. All complications would be reversed. I’d be perfectly healthy in all ways. Easy peasy.
In the last few years, I’ve started to wonder if I’ll see that cure in my lifetime. And that reality has bred a new definition of what my “cure” may be.
Living with diabetes for such a long time has changed my perception of what a cure means for me. And I stress the “for me” part, because every person with diabetes has a different view of that cure. For some, a cure is that definitive reversal of autoimmunity, leaving insulin-producing cells happily intact. Others view a cure as some kind of islet cell transplant. Some people with diabetes find their vision of a cure in the realm of technology, using self-monitoring and regulating versions of an insulin pump and continuous glucose monitor. (Let’s see which version of “cure” insurance companies feel like covering, but that’s a whole different column.) And in some instances, a cure for diabetes means prevention of the development of type 1 and type 2 diabetes in our children, eliminating new cases of diabetes and thus “preventing” the disease out of existence.
A variation of my “cure” could include wearable hardware that helps regulate my blood sugar and insulin needs without my input. My “cure” could be a device that I wear or a device that is surgically implanted. When I read about The Artificial Pancreas Project, I see that this hardware-based cure may in fact happen in my lifetime. But I also believe that cell encapsulation (like the studies taking place at the Diabetes Research Institute) could also be the answer to type 1 diabetes. The definitions of what might cure me vary, as do their methods.
If you asked me what a “cure” would be for me now, it would be less about physiological changes. I’m okay with not making my own insulin. I’m not okay with the fear and worry that seems to come in tandem with a diabetic life. A cure for me is something that eliminates the worry. Something that makes me feel confident getting into my car and driving long distances with my daughter buckled into her car seat. Something that makes my husband and I dream about our fiftieth wedding anniversary without that quiet moment of maybe. Something that helps my mother sleep at night without worrying about her grown-up daughter. Something that makes me feel like I’m going to be okay for a long, long time. It’s an emotional answer to the question of a cure, but it’s the one that fits best in my heart.
But that’s just a version of the cure as I see it in my mind. Because as the person with diabetes, I know I need to manage my own expectations. After twenty-four years and just as many awareness walks every fall, I don’t expect science to come knocking on my door and shouting “Eureka! We found a way to reignite your islets!” I keep my hope locked in a quiet cage. If a real autoimmune cure is discovered, I’ll be banging on the doors first thing that morning, but I’m not going to remain camped out on the sidewalk for the next five years.
Now that I am an adult, with more than two decades of diabetes under my belt, I better understand the effects of diabetes on my body. I’ve watched my eyes pepper with cotton wool spots, and now the beginning of retinopathy. I’ve watched the lab slips that once just contained an A1C draw include a laundry list of “things” to watch out for, now that I’ve had diabetes this long. I’ve seen the effects that a pregnancy with type 1 diabetes had on my body, and I realize how fragile this disease makes me at times.
I also better understand the effects of diabetes on my mind. I have seen how diabetes has given me a strength and determination that I believe came as a result of dealing with issues of mortality at such a young age. I am in tune with my health and my body in a way that those living without a chronic illness can’t really duplicate. I have a deep appreciation for each and every day that I feel healthy and strong. Diabetes has made me grateful for things that others take for granted.
A cure for diabetes is something I have hoped for, both openly and privately, since I was diagnosed. I still support research and funding; I still walk and raise awareness. And I still hope, even when the shape of that cure shifts with time and technology.