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November 14, 2003

Other Social Issues

Question from New Delhi, India:

At present I am 28 years old, have been suffering from type 1 diabetes, and have been using human insulin for somewhere around nine years or so. Now I am getting married, but unfortunately my fiancee does not know that I have diabetes. I have a few questions: What are the mandatory medical tests that must be done and the reference ranges for each test? What are the other alternatives for carrying insulin? What I want is a compact arrangement that is not cumbersome, can be carried or used anywhere (say in office, gym etc). Also, I want this arrangement to be very compact so that it can be easily concealed, as I do not want my fiancee to know about it. I am underweight by almost 9 Kilogram want to gain some weight to look normal. I have been going to the gym and undergoing weight training for almost an year, but this has not helped me. Please can you advise on this?


You could consider a pen system for your injections. Your other alternative is an insulin pump which is small, compact and easily concealed. Most individuals think it is a pager or similar device.

However, and I strongly emphasize this, you should not conceal the fact that you have diabetes from anyone. No matter what the culture or society we live in, particularly 2003, one should be up front with ones loved ones. You may need their help and may be surprised with the support.

Additional comments from Jane Seley, diabetes nurse specialist:

I know this is not really answering any of your questions, but I have to tell you that I am very concerned that you are living alone with your diabetes with no support. For one thing, I think it is really dangerous to work out and not have others know about your diabetes, the possibility of hypos, and where you keep glucose tabs or whatever while you are working out.

I used to care for a lovely young woman with type 1 diabetes who told no one and therefore had to frequently not test, skip or delay insulin doses and so forth. She often had to run high, especially when she was on overnight business trips because she was so afraid of a hypo in the early morning and that co-workers would find out. We talked about her reasons for not telling anyone and ultimately she was able to tell one friend as an experiment and learned that the reaction was very different than she had feared. Soon after, she met a wonderful man, married (I danced at her wedding!) and now has two beautiful children. This would never have happened when she was living her secret life.

I strongly encourage you to tell your fiancee before the wedding, or your secret will always be a wedge between the two of you. You may find that she will be very supportive, and it may deepen your relationship. Diabetes can be controlled and you can live a long and happy life with diabetes. Please think about what I have said and talk to a health care professional if you need some help with this.