A Doctor's Motivation
When I was diagnosed with type 1 diabetes, I was lucky. At 23, I was beyond the hormonal fluctuations of puberty and past the push-your-limits attitude of college. Better still, I was a first-year medical student. After the diagnosis, I read Living With Diabetes and The Joslin Guide to Diabetes cover to cover. I knew all about the different insulins, checking my blood glucose, counting carbs, and potential complications. I knew it all. I was ready—or so I thought.
Four years later, I began my residency in internal medicine. That meant longer hours, more erratic mealtimes, and less time to exercise. I might have noticed that my A1C was creeping up, except that I saw my endocrinologist only every six months or so. I tended to push my diabetes to the side between visits.
One of those visits provided my wake-up call. My A1C had risen to 8, and my doctor really laid into me. I broke down crying in his office. Wait, I thought, I'm a doctor: How did I let this happen? Of course, like anyone else with diabetes, a doctor can know exactly what needs to be done, but doing it is another matter.
After that, I started making a conscious effort to take care of myself. I got even more serious once I decided that I wanted to have a baby. Planning for motherhood meant reading all the books for pregnant women with type 1 (sadly, there aren't many) and getting my A1C down to a nice 6.3. I was prepared. Then, in my third year of residency, the happy news: I was pregnant!
I had to test and adjust my insulin more often to handle all the changes in my body. It was hard work not to fall into old, bad habits. Nine months is a long time to be perfect.
In 2005 I delivered a healthy baby boy. Along with the joy and excitement of giving birth to a child came a feeling of complete relief. I was tired of worrying about how my diabetes was going to affect my son. I felt ready to test less often and take less insulin. After being tough on my diabetes for so long, I was tempted to slack off.
Fortunately, my work as a hospitalist (a physician who sees only hospitalized patients) helps keep me motivated to take care of myself. I treat many people with uncontrolled diabetes and heart complications. They are a constant reminder of why diabetes care is important, and of how difficult it can be.
Now I'm 34 and have two children. I try to keep my doctor's appointments every three months, not six. I watch out for highs and lows, and try to predict my A1C. With every visit, I rededicate myself to my diabetes care and to my children. I want to be there for them—and for their children.
Diana Childers, MD, is a hospitalist at the University of California–San Diego Medical Center. She and her husband, Richard, have two children, Luke, 4, and Kiley, 1.