Because the doctor who diagnosed my Type 2 diabetes had been so unhelpful, my girlfriend—who around that time coined the term "diaboyfriend"—and I performed copious research on the Internet; I radically adjusted my diet. The goal is to keep blood sugar levels relatively steady by avoiding the kinds of foods that would cause a spike. Contrary to popular belief, plain old table sugar isn't the central villain in the diabetic's dietary life: it's also the many different types of carbohydrates that quickly break down into sugars, including all refined ("white") grains and flours, which means that diabetics can't eat anything. Not literally, but it means that the staples of a New York diet are things they should generally avoid or enjoy sparingly: breads (bagels! sandwiches! falafels!), pizza, pasta (even most "whole wheat" pastas are made from a white-flour blend), crackers, white rice (sushi!), muffins and beer, not to mention sugary drinks (no lemonade, not even juice), and, of course, essentially every dessert. Even sugar free desserts are ill-advised: nearly all contain "sugar alcohols," which raise blood sugar levels, just not as severely as pure sugar. Sugar-free cookies are often made with white flour. They may as well just use sugar.
Fruits are encouraged—they contain "good sugar"—but in moderation, and except for certain varieties, like watermelon and pineapple, that rapidly break down. The healthiest foods are beans and vegetables (but not corn, which is too starchy), some nuts and whole grains. I began eating oatmeal every day for breakfast. And a lot more tofu. I took my pills at breakfast and again at dinner.
Still, my blood sugar remained dangerously high, although the unquenchable thirst had abated and the night cramps were fewer. I was still losing weight: at six feet tall, I had fallen below 130 pounds. ("I wish I had diabetes," my girlfriend said.) I still felt lethargic, and the leg pain persisted. But my eyesight had improved: for years, I had worn corrective lenses for mild nearsightedness; now, I was seeing 20/20. I felt like Peter Parker after the spider bite. (The clarity only lasted a few days before my vision blurred again; an ophthalmologist later explained it was the result of a change in blood flow, essentially a temporary and artificial fluke.)
A few weeks later I went back to the first doctor I had seen—not that cruel diagnoser—who told me he couldn't tell if I had Type 1 or Type 2. I needed more tests.
A diagnosis of Type 2 diabetes had been scary enough; Type 1, I thought, would be devastating. I struggled to convince myself that it was the former: that I was too old for Type 1 (not true), that I had shown some improvement on the anti-insulin-resistance medication (which didn't really prove anything). They took more blood. I waited.
Over that weekend, I went to a wedding and saw an old-friend who had been a Type 1 diabetic since childhood. I told her about the recent diagnosis. "Type 1 or 2?" she asked. "They're not sure yet," I said. "Well, if it is Type 1, let me give you some advice," she said. "Don't eat pizza. Your blood sugar might be fine, but then a few hours later, all of a sudden, it'll be really high, like, where did those carbs come from?" I nodded. "Anyway," she said, "I hope it's not Type 1."
"Yeah, me too," I said. "No offense."
When I returned to the doctor a week later, he looked at me solemnly. My insulin levels were negligible. I had Type 1. He told me delicately, as I had imagined a doctor would. He explained what my insulin regiment would look like, the sorts of changes I'd have to make to my lifestyle. Again, I applied all of my energy to holding back tears.
"Honestly," he said, "if I had to choose between feeling like you've been feeling or injecting myself with insulin twice a day, I'd take the insulin."
Easy for you to say.
I cried the whole way down 56th Street.
The next day I got syringes and insulin from the pharmacy. (Without health insurance, this was getting expensive.) I went home and did like a nurse had shown me: wiping down the ampoule's top with an alcohol pad, doing the same to my leg, pulling the milky liquid into the hypodermic, flicking it to check for air bubbles, jabbing it at a slight angle into my outer thigh, descending the plunger. Surprisingly, it didn't hurt at all, the needle numbly sinking into the flesh. For the first time in my life, I realized I could be a heroin addict if I so chose.
"I just stuck a needle in my leg!" I texted to my girlfriend.
"You're so brave."
"I know, they should write children's books about me."
By afternoon, my blood sugar was way down—to, like, normal levels. The next morning I rode the subway to work and, before I'd transferred to the D, I felt my body temperature rise. Was I having a stroke? It took me several minutes before I realized the flood of energy was the insulin kicking in. My pulse was normal. My pupils weren't dilated. I felt like I was on drugs.
Technically I was. The leg pain ended abruptly. Slowly, I started to put weight back on. I danced spontaneously in the mornings.
Diabetes did me a lot of good: it helped me to get to a proper weight. I'm eating healthily. I'm exercising regularly. And, because of the twice a day insulin injections, I'm living on a disciplined and domesticated schedule: I'm waking up well before I have to leave for work, I'm cooking nearly all of my meals, I'm sleeping better, I'm (usually) home at a reasonable hour, I'm getting a lot more work done: writing more, reading more, watching more movies. I didn't just feel better: Every aspect of my life seemed to have gotten better. I had transitioned from the misguided sense of invincibility that commonly afflicts young people into the health-consciousness, the responsibility, of adulthood. And all it took was a life-changing malady.
I tried to explain this to my doctor the last time I saw him.
"Diabetes has been kind of good for me," I began, but he cut me off. "Well, when you're older, we're going to have to put you on blood pressure medication, even if you don't have high blood pressure, because it helps with your kidneys." Kidney failure is a common complication of diabetes; many diabetics wind up on dialysis. "And you're going to have to see a podiatrist once a year," because diabetics often develop dangerous sores and ulcers on their feet, which in extreme cases can result in amputation. "And you're going to have to see the ophthalmologist once a year," because diabetes is the leading cause of blindness in the United States. Diabetics are more susceptible to the flu and those who inject insulin run the risk of hypoglycemia, in which blood sugar levels fall too low, producing a shaky and sweaty disorientation that, at worst, can result in seizure or coma. Right—I guess I didn't mean it literally, doc. Diabetes sucks.