Hey everyone, Earlier this week I posted this thread on my Instagram, but I wanted to send it here so you could read it in one place. It contains my somewhat cohesive thoughts on what diabetes awareness means in 2023. I'd love to know what you think!What is diabetes awareness? November is National Diabetes Awareness Month, capped off with November 14th’s World Diabetes Day. More than any time of the year, the conversation centers around diabetes and all its nuances. There will be events and campaigns from diabetes brands, walks and fundraisers from non-profits and storytelling from individuals in various communities in their own ways.

But when most people on earth either live with or have already heard something about diabetes, what is diabetes awareness?

I’d like to frame it into three phases:

Where we’ve come from:

101 years since Banting and Best administered insulin to Leonard Thompson, discovering the treatment of Type 1 Diabetes, and providing a way for patients to live with diabetes.

IT’S STILL EARLY! Now more than 1.6 million people live with T1D and over 8 million take insulin daily in the US alone! Some are living with T1D well into their 80’s and 90’s. What used to be a death sentence is now a manageable chronic condition.

On my bad days with diabetes, I try to remember that if I were born at any other time in history, I would be dead from my diabetes. What a happy accident that I get to live and thrive with T1D! Millions of others have gone before me and millions more will follow.

Where we are:

Unfortunately, despite amazing developments in treatment and technology in the first 100 years, there is no cure for diabetes. 50% of diabetes patients globally do not have access to insulin they need, while 1 in 4 patients in the US have rationed insulin at some point, and in some countries the cost of diabetes totals more than 50% of household income.Continuous Glucose Monitors and Automated Insulin Delivery systems round out the top-end innovations, but patients ability to access these technologies depends highly on coverage, income and politics.Around 8,000 endocrinologists in the US are expected to treat in excess of 30 million patients. And despite great examples of individual achievements and stories, much of the diabetes narrative has been status quo.Stigma runs rampant online, and the type of diabetes you live with often informs the public’s not so subtle opinion on whether or not you deserve respect or are even worthy of care. In fact, the unsolicited feedback from strangers, peers and family could be the worst of all diabetes scourges.

Where we’re going:

Living with diabetes often forces you to become relentlessly positive, often employing a growth mindset to avoid becoming too negative about the ups and downs of the disease. In the spirit of that, I am optimistic about the future of diabetes.

Right now, there are patients who are experiencing beta-cell replacement therapy, and have traded their multiple daily insulin injections for immunosuppressants - a functional cure with promising outlook. A new drug TZield has come to market which can delay the onset of T1D as much as 3 years! Drugs like Ozempic and Trulicity are providing insulin sensitivity and weight loss to millions. New technology in review with the FDA promises a future with less mental burden and more automation. There may come a day soon where counting carbs could be something we collectively reminisce about the same way our parents/grandparents remember listening to weekly programming on the radio. For now, we can watch these developments closely and only hope that when they are ready for mass distribution, we will have the coverage we need to be able to get them.

What is diabetes awareness? It’s learning that diabetes is the disease with too many inputs. That the people you know with diabetes have thought about it more than you could possibly fathom, about everything from ways to get more sleep or to just make it through their trip to the gym without ingesting a bagful of skittles to avoid passing out.It’s making peace with the fact that no one did this to themselves on purpose, and whatever homeopathic treatment your aunt learned about on tiktok isn’t the missing piece to a stranger’s diabetes management.It’s holding space for both sides of the coin: Diabetes is awful, unrelenting and unfair - and you are capable of living the life you dreamed of in spite of it.

So this diabetes awareness month, know that awareness starts with seeing and noticing. I see you. I know you. I am you. And what’s more, we’re in this together. Keep going, we’re still early.-Rob