From the Mailbag: Diabetes and the Single Life

A wonderfully candid letter from a kindred spirit, which appeared in my mailbox last week:

Dear Amy,

I totally related to your November 26th post about feeling “displaced” as an adult with type 1 diabetes. So much is said about adults with type 2 and children with type 1—and more recently children with type 2—that we grown-up type 1s seem to fall last on the list. I would LOVE to attend a camp or other type of bonding event where we could all commiserate about our daily struggles and how the rest of the world just doesn’t understand!

While we’re at it, I’d like to focus a bit of attention on an adult sub-group that is perhaps even MORE overlooked: Those of us who are SINGLE, and beyond that, single and living alone! I have no idea how many of us there are, but I have met quite a few over the years. I wrote an article on the subject for Diabetes Forecast magazine after moving into my own apartment in 1999.

Although I still love my apartment and my single life, I admit that living alone has adversely affected my diabetes control. Back when I had roommates, my A1cs averaged in the 6.5%-6.8% range. Since moving in by myself, they’re more like 7.0% to 7.3%. That’s because I’m always erring on the side of caution, letting my sugar run a bit high rather than risk a nighttime low. Not a bedtime goes by when I don’t say a little prayer that I’ll wake up the next morning. I’m sure all type 1s understand that feeling, but it’s gotta be worse for those of us with no one around to catch us if we “fall.”

My mother, who lives more than 200 miles away, worries about me constantly. She still has vivid memories of urgently feeding me orange juice—and administering the occasional glucagon shot—after I was diagnosed at age 9 in 1973. Like many mothers, she pesters me about getting married. But in this case, it’s not as much about giving her grandkids (thankfully, my sister did that). I keep having to tell her that I’m not about to get married simply because of my diabetes!

But she does have a point. Beyond the concern about hypoglycemia in the present, she worries about my future: Will there be anyone to take care of me if/when my diabetes—or even other another health problem—finally catches up? Of course, this isn’t just an issue for current singletons. These days, type 1s are such a healthy bunch that many who are married could easily outlive their nondiabetic spouses…What then? I don’t mean to ruin anyone’s day, but it’s something important to think about!Kiss

On another adult type 1 front, becoming a first-time “pumper” just a few weeks ago has re-focused my attention on my single status—It was one of the major reasons for my longtime refusal to wear a pump, despite the obvious health benefit. I didn’t want some yucky-looking medical device on my body that might put off potential dates! I still sort of feel that way, but am actively trying to get over it. After all, I keep telling myself, any guy who’s squeamish about my insulin pump probably couldn’t have handled my previous 5-8 shots per day habit, either!

But then there are—speaking of “adult” topics—certain “practical” pump considerations…Yes, I’m talking about sex! As a new pumper, I’ve got questions: I’ve been told that you simply unhook when you do The Deed. But, um, you’re not supposed to leave the pump off for more than an hour…What if you want to “go at it” longer?! And with the pump off, how do you prevent your partner’s body from accidentally rubbing up against the infusion site—or for you OmniPodders, the Pod itself—and dislodging it? Has that ever happened to anyone?

Does anyone keep the pump on during sex? If so, what do you do with it while you’re “Doing It??”

Whew. Well, that oughta get the campfire discussion going… Amy, thanks so much for providing a forum and for your extraordinary hard work in keeping us informed about All Things Diabetes. You are an invaluable resource and a real treasure. Very best wishes for a happy and healthy 2008!

Cheers,

Miriam E. Tucker
Health/Medicine/Lifestyle Writer
www.miriametucker.com

* * *

Dear Miriam,

Well… one thing I can tell you is that the OmniPod does press into me rather uncomfortably in intimate moments. As noted, my husband’s a pretty big guy. But we’ve also been together seemingly since time began (married for nearly 18 years now), so nothing I say or do surprises him much. I most certainly understand that the dynamics are different for singles.

Any suggestions, Dear Readers?

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27 Responses

  1. C
    C January 15, 2008 at 7:06 am | | Reply

    I use the Omnipod, and I like that I don’t have to take off my pump during intimate moments~ I wouldn’t want to be watching the clock the whole time, and I can use a temp basal to prevent mid-sex lows (the worst!). I was nervous about being intimate with the Pod on at first, but found it best just to make a joke about it and move on. My boyfriend assures me that a little piece of plastic isn’t going to stop any guy from going for the gold, so to speak. I think as long as you have discussed your pump beforehand with the person you are sleeping with, they will be prepared to see it and it shouldn’t be much of an issue. They’ll probably be too busy checking out the important bits =)

  2. mollyjade
    mollyjade January 15, 2008 at 8:14 am | | Reply

    I’m another single, adult type 1. This always feels very morbid to say, but my current financial strategy is to save up enough money to deal with when the diabetes “catches up” with me as you put it Miriam. Who knows what kind of care I’ll need when I’m 70 (and I do plan to make it to 70!)

  3. Ben
    Ben January 15, 2008 at 8:46 am | | Reply

    If it’s not bad enough feeling “displaced” being in my late 20′s as a Type 1, imagine not being able to even come close to affording a pump and seeing what amounts to crocodile tears over whether the dude who’s going to do you cares about you being diabetic, combined with your weaselly, cosmetic worrying about your life-saving device. Wise up for a minute – your pump keeps you alive and anyone who isn’t willing to deal with it at every moment of your life isn’t someone worth dealing with for even a moment.

    I take a minimum of six injections a day, and easily hit twice that. I have no compunction about injecting in front of people and have no patience for the eternal “Oh, but I hate needles!” responses. If I could afford a pump, I’d wear it on my goddamn head if I felt like it.

  4. Karen S.
    Karen S. January 15, 2008 at 9:58 am | | Reply

    Miriam…

    I understand where you are coming from. I just wanted to add something about the sex comments. First let me say…if sex lasts more than an hour WOW! Way to go! LOL..just a little humor to lighten the mood. Seriously, though if you are disconnected during that time don’t forget you are “exercising” so to speak so your sugars may not sky rocket. I normally disconnect during intimate moments b/c I will go low if I don’t. So…don’t freak out about that. I seriously doubt that being disconnected from your pump for an hour would lead to DKA or something “bad”. Just make sure you give yourself some insulin when you put the pump back on and always remember to re-connect. I have friends who have fallen asleep afterward and forget to re-connect to the pump!

    I hope this helps!!

    ~Karen

    P.S I was

  5. baddecisionmaker
    baddecisionmaker January 15, 2008 at 10:01 am | | Reply

    another single type 1 adult (i guess? i still refer to other people as “grown ups” in contrast to myself, but i’ve been out of college, at my job for over a year and getting an apartment this week) here.

    I do not want to live alone because I like living with people, it’s cheaper, and because I want someone around in case of a serious low or something. I also worry about the long long term though, because I could definitely see myself never getting married and/or never having kids. It scares me. And also seems like a bad reason to decide to get married or have kids.

    Re: sex – just take the pump off. If you’re really worried about it being over an hour with no break, you could put it in a “thing thing” and leave it on. It’s possible your site could get ripped out, but if you feel comfortable telling your partner where it is, less likely. Also, what’s the worse that could happen? If it gets ripped out every once in a while, that’s just a sign it was good :-) and you were going to have to change the site sooner or later anyways.

    I’m having other issues right now – like feeling weird about feeling sick/tired all the time (having some MAJOR high blood sugars and insulin absorption issues) and not wanting to do anything or having the energy to go somewhere. Which is especially weird with a casual acquaintance that I don’t have a close relationship with, and one that doesn’t seem too comfortable talking about illness.

  6. anonymous
    anonymous January 15, 2008 at 10:12 am | | Reply

    I actually leave my pump connected for sex. Every now and then I’ll take it off, but I find it really doesn’t get in the way. I use the long tubing, so we just set it to the side. Sometimes we have to “reposition” the pump, but it really doesn’t get in the way. This was my approach as a singleton, and now as a married person.

  7. Sarah
    Sarah January 15, 2008 at 10:30 am | | Reply

    I tend to leave my pump connected next to me in bed during intimate moments – though to be fair, we’re not exactly swinging from the rafters (metaphorically speaking) and if we were, I’d disconnect. The Cozmo does have a disconnect feature that will let you bolus for what you would be missing in basal insulin – very handy in this circumstance and many others.
    I hear you on the “how to not scare people away” aspect with the pump and diabetes. Frankly, I find the pump to be easier to manage in public than injections. Fewer stares, less weirded-out looks, etc. although I do still get the “oh, I could NEVER do that” when I test.

  8. Sarah
    Sarah January 15, 2008 at 10:42 am | | Reply

    I’ve had a pump almost thirteen years. I haven’t been active sexually that entire time, but fairly close! I have never felt like it got in the way. Sometimes I keep it on, sometimes I disconnect. Sometimes I disconnect in the middle. I’ve also never had a sight ripped out by sex, but a few door handles have gotten me!

  9. George
    George January 15, 2008 at 12:28 pm | | Reply

    C said:Who knows what kind of care I’ll need when I’m 70 (and I do plan to make it to 70!

    and George responds: I am 71 now, have been diabetic for 43 years, have no complications at all, and plan to be here when I am 91 – You never get old if you have the right attitude. AND – we still do it! – sometimes with the pump on and sometimes with it off.

  10. Dina
    Dina January 15, 2008 at 2:20 pm | | Reply

    GEORGE THAT’S JUST AWESOME! YOU GO!

  11. Angela
    Angela January 15, 2008 at 5:38 pm | | Reply

    Welcome, fellow cyborg, congratulations on your decision to start pumping! Once you get used to the pump, you’re going to be just fine. Think of the it as screening for your dates. Men who can handle your illness are more likely to be kind and compassionate people. First date with my husband, I checked my blood sugar in front of him, explained “highs” and “lows”, and fed him a glucose tablet. I believe in full disclosure. =)

    Now that we’re married, the pump stays on during sex. Sometimes it gets tangled up – we just laugh and move it. Heck, sometimes your legs are going to get tangled up, or his hand will get caught in your hair, it’s the same thing. Your pump is part of your body now. Sometimes when it gets wild, I do take it off. I just take a look at my sugar afterward and correct if necessary. It isn’t usually. In fact, I have had some dangerous lows during sex, for which reason I keep a juice box next to the bed.

    Even with the pump off, I’ve never had the site pulled out of my body, the Minimed pump site is very secure. (The Minilink CGM transmitter is not so much, I just make sure to tell him which side its on and he stays mindful of it.)

    Best of luck with your new pump. I hope you find it as beneficial as I have.

  12. Kelly Kunik
    Kelly Kunik January 15, 2008 at 6:44 pm | | Reply

    Miriam -

    Get the pump and don’t worry about the what if’s. You need to get on the pump and figure out the idiocycricies(sp)as they happen, not before.

    Dina’s right, the pumps a great screener for dates, and you don’t want to deal with anyone who doesn’t want to deal with it.

    As far as sex with the pump – anything goes. Leave it on, take it off, or leave on for the first round, and take it off for the second. Whatever works!

    I’ve had the infusion set rip out a few times and guess what? It’s actually funny, a private joke between the 2 of you.
    It won’t take you off course,so just go for it and get the pump!

  13. Miriam
    Miriam January 15, 2008 at 8:50 pm | | Reply

    Thanks so much to everyone (Ben included!) for all the helpful and supportive comments. Hopefully your answers are also helping others out there who were wondering some of the same things. What a great community this is!

  14. NPs Save Lives
    NPs Save Lives January 16, 2008 at 6:41 am | | Reply

    I’m glad that the subject of sex came up. So many people with health problems push sex into the secondary through embarrasment issues. If the person you want to be with has a problem, they were wrong for you anyway. My husband is a diabetic and I’m getting ready to look into the pump for him. Stay healthy!

  15. Bernard Farrell
    Bernard Farrell January 16, 2008 at 10:39 am | | Reply

    Two things to be aware of. Infusion set placement can be difficult during sex. For example, I used my thighs once and the edge of the infusion set (slightly sharp) was an issue. But when I used the little cover that I get with each infusion set, that made the effective edge rounder.

    If you need to take a pump off for longer than about 20 minutes, you can always reconnect briefly and take a small bolus if you need it to be off for longer. Yes, than can change the mood, but it’s not as horrible as it may sound.

    I generally disconnect it. The only danger there is that you may forget to re-connect. I did that a few times and ended up with really HIGH blood sugars. So remembering to check your blood glucose levels afterwards is a good way to remember to reconnect the pump.

  16. CALpumper
    CALpumper January 16, 2008 at 11:58 am | | Reply

    Miriam,

    Looks like everyone that commented covered every aspect of your questions. Yes this is a great community. I have to say, at any age these are the things we think about and it is wonderful to hear!

    I have tried on/off, stomach, buttocks. It does not matter where the pump is or the inset (site). Most important is how comfortable you are. And more importantly (been diabetic for 23 years, I am now 29 and back in the single scene), if you meet someone who gives you “that look”, walk away.

    This disease can seem daunting (mainly to ourselves as we live with it every moment of every day) but we maintain it and can enjoy our lives. We are more cautious, more prepared and have to consider/think about much more on a regular basis then the “everyday person” does.

    Hang in there. It is tough out there in the single world but there just has to be someone for us Pumpers! ;-)

  17. jadesr
    jadesr January 16, 2008 at 2:07 pm | | Reply

    Well, I know everyone will jump on me for this, but I am a single female with Type One.
    I keep the fact that I have it a secret as long as possible into a relationship.
    Let’s be honest: when you first meet someone and are sizing them up, you take their baggage into account, and a chronic illness with all the monetary, reproductive, and life planning issues would scare away anyone, even the good understanding ones.
    So, my strategy is to hide it, make sure they are hooked, and then tell them in an “… oh, by the way,” manner. Then, since I have hidden it from them, they see that it does not impact their lives at all, and they are more likely to be cool about it, and not get scared away.
    Of course, this means no pump, but I would never use a pump anyway, so it works for me.

  18. Lauren
    Lauren January 17, 2008 at 2:03 am | | Reply

    I understand the “fear of discovery.” While I’ll glare at a stranger who grimaces when I pull out my needles, I tread lightly when it comes to some people I’m close to. I have my ten year high school reunion this spring. If I’m pumping/podding by then, I will probably switch to injections for a few days. I don’t like the idea of an old crush giving me a friendly hug and feeling a strange lump on my side. I wasn’t diabetic in high school or college, so I’ll have some explaining to do. The question of disclosure is a tough one.

  19. AmyT
    AmyT January 17, 2008 at 10:28 am | | Reply

    You guys are awesome. Where else can we “get together” and discuss this kind of stuff?

    Thanks!

  20. Jason
    Jason January 17, 2008 at 12:08 pm | | Reply

    Jadesr,

    What explaining to do think you have to do? To whom and why? Do you really think you owe anybody an explanation for how your pancreas functions?

  21. Jadesr
    Jadesr January 17, 2008 at 4:34 pm | | Reply

    Well, like I said, I don’t. I take great pains to make sure no one knows I am diabetic. I imagine friends, coworkers and dates just think I spend a weirdly long time in the bathroom.
    But, if I were to find myself in a serious romantic relationship, like the ones being discussed here, at some point I might mention it.
    Altho, it might be a fun challange to see how many years of dating or marrige I could get through and still manage to keep it a secret.

  22. Ben
    Ben January 18, 2008 at 5:26 am | | Reply

    Hey Jadesr:

    You’re fucking stupid.

    By the way: My email address is brossa@gmail.com, just so no one thinks I’m hiding anything (unlike you!)

  23. Jason
    Jason January 18, 2008 at 11:55 am | | Reply

    I wouldn’t insult you for your decision — it’s your business, certainly. And I suspect you’re mostly kidding when you suggest keeping it a secret within a long-term relationship.

    If the tables were turned and you found that out about your partner years after dating / marriage, you’d rightfully be pissed. Not to mention the fact that if you needed medical assistance, your partner wouldn’t have a clue.

  24. Jades
    Jades January 18, 2008 at 3:05 pm | | Reply

    Thanks, Ben. It is exactly your kind of compassionate understanding that makes me seek out groups and forums like this. It warms my heart the same way my Dr. yelling at me to bring my sugars down and then not even looking at the meticulous food/insulin/workout diaries I keep leads me to love the medical establishment.
    Miriam seemed to be concerned that guys she just meets might be oooked out by her pump; some of the other posters advocated full exposure right away. I am taking the opposite view. First dates are no time to hash over your bummers or weaknesses. I wouldn’t tell a new date I am diabetic the same reason one would not lead by telling a potential love interest that you have massive debt, a bad credit rating, or a bastard child you ran out on. You wait until it is a need-to-know thing. And with a pump that might come up sooner.
    I did once try telling a guy I had just met about it, and it was a DISASTER! Dinner turned into a long diabetes education class, precluding discussion of the many, many other aspects of my personality. Meaning I got defined as ‘the sick girl’ when in reality my illness is just a tiny part of my life.
    If wanting my dates to think of me as a hot, successful, intelligent person instead of ‘that chic with diabetes’ makes me an f-ing idiot, than fine: I am an f-ing idiot.

  25. Jadesr
    Jadesr January 20, 2008 at 2:01 am | | Reply

    … and I was not going to go to personal attacks as you did, but then I re-read your post to Miriam, and changed my mind.
    Maybe if you spent less time posting vitrolic insults to strangers on line, and more time building your career, you would be able to afford a pump.
    Just sayin’

  26. Miriam
    Miriam January 21, 2008 at 6:16 pm | | Reply

    I feel I should chime back in here, since I started this thread…

    First of all to Ben: So you disagree with Jadesr, fine. But a personal insult–particularly one invoking the F-word–is totally uncool.

    To Jadesr: If it’s working for you, great. But I would echo the concern about the partner being upset once they finally DO find out, and also the potential risk if you have a severe hypo and they have no clue.

    I take a completely opposite perspective to dating. Although I’m angsting about the pump now, I’ve never been shy about discussing my diabetes or even injecting in front of first-time dates. And I actually LIKE the “diabetes education” discussion! Why? Because people are always interested, and because explaining diabetes is something I’m really GOOD at!

    I definitely don’t lump my diabetes into the same category as massive debt or a bad credit rating. Those are true negatives. Diabetes is a relative one…Just as in politics, it depends on how you “spin” it!

    Plus, diabetes doesn’t have to dominate the entire discussion. You can certainly talk about other things too. It doesn’t have to be all-or-nothing.

    Speaking of shifting topics, I also wanted to thank everyone who noted that pulling out an infusion site is no big deal. At the time I sent Amy the letter, I thought that if you did that, you had to do a whole new set change–i.e., fill a new resevoir, rewind, prime, etc. Someone just told me all you have to do is insert a new catheter and switch out the tubing…I mean, DUH! Life is easier now! :)

    I also just recently learned about the “auto off” feature that allows you to program a duration–say, 10 hours–after which the pump will shut off if no buttons are pushed, and issue an alarm followed by a siren that hopefully is loud enough for the neighbors to hear. Having that safety feature helps put my mind at ease as well.

    Thanks again everyone…And let’s all continue to be nice to one another!

  27. annonymous
    annonymous January 28, 2008 at 9:41 pm | | Reply

    As a now single adult woman, who has been in a longterm relationship and wears a pump, I can tell you that I usually keep it on. I’ve made the mistake of leaving it at the boyfriends house, driven part way home, wondered why I wasn’t getting any reminder beeps, and had to drive back late at night. With long tubing, it usually stays out of the way. Plus, when I orgasm I tend to go high after, so I try to remember to bolus after that, just a little, even with the exercise. But that’s just me.

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