There's a lot of information people should share with each other, but they do not for various reasons.  There are many reasons why someone would do that.  Some reasons that come to mind off the top of my head are: that person doesn't feel comfortable sharing those details due to past trauma and negative experiences, or maybe they are still not done processing all the information surrounding the issue, or maybe that person is very deeply anxious/sick/overwhelmed and can't even understand what is going on to begin with.  Anyone who experiences constant overwhelm will try not to cause others the same.  If a friend has too much going on in their life, it would be wrong to overwhelm them further with details about your own struggles at that time.  During hard times when everything is overwhelming for everybody, this does create a problem.  When things go unspoken for too long, when unanswered questions remain just that, when nobody has the relevant information necessary to move forward, lots of conflict and miscommunications arise.  Sometimes I wish we could normalize, as a society, asking someone before speaking: "Hey, do you have the capacity for this?" I wish I could remember to do that myself, but I often can't. Because there is a lot going on: in daily life, in our own bodies, and in the world.  Some people can keep up with that and others cannot, but I would bet that everyone struggles with this often.

I met someone a while back who shared an important detail about themselves as they introduced themselves to a group.  They said: "Hey, my name is {insert name}, my pronouns are they/them, and just to let the group know - I am autistic."  It kinda blew my mind at the time because I was thinking WHOA I didn't know we're ALLOWED to do that! But that was really helpful context to know about this person when proceeding to communicate with them, especially since we were meeting for the first time.

This made me wonder, what is something that completely rules over my life and has a deep impact on all aspects of it.  What is the most relevant detail I would need a new person in my life to know, assuming I had to pick just one - the one that was deeply important for anyone around me to know.  I would likely say: "Hi, my name is Alex. My pronouns are she/her but I don't really care what you call me.  I am a type1 diabetic of 12 years who is also neurodivergent."  That already sounds like a mouthful and like it would cause someone else overwhelm or information overload.  I can see why we don't normalize that as a society (but that doesn't change my wishes).

When I first got diagnosed, I had some friends who approached me insisting that I meet their diabetic friends.  They said it would be helpful, supportive, and informative for me.  Sometimes it was, but sometimes it wasn't.  A lot of T1 diabetics I have met were neurotypical.  After 12 years with this disease, I see how that distinction is important.  It means we do have the same disease, but our experiences of it are very different.  

T1D is a disease that requires round-the-clock monitoring, including when you are sleeping.  It requires a lot of meticulousness regarding health routines, eating schedules and diets, exercise, mental health management, supply management, routine doctor appointments, constant health insurance wrangling, and also constant information being presented to you.  Often this information is new and complex.  Sometimes this new information contradicts past information which requires a lot of brain processing, further research, and personal discernment.  For example: my endocrinologist (diabetic doctor) told me at one appointment that she will put me a different brand of fast-acting insulin so that I didn't have to wait 20 minutes before eating after injecting myself for a meal.  But this didn't help me out, and months later, another endocrinologist told me that the information she gave me was incorrect.  I still had to wait those 20 minutes.  That was very confusing for me, but it happens a lot with this disease.

One question I like to ask other T1D'ers is: Do you ever forget about your diabetes? Some people find that question ridiculous, some people reply with "sometimes I do, sometimes I don't", others reply with "JFC I DO THAT ALL THE TIME WHY IS IT SO STRESSFUL".  Out of all those people, the last one is the one I relate to the most, and would feel most comfortable sharing with because I know our experiences of this disease are more similar than not.

I am a low-capacity person with a very slow brain processing speed.  It takes me a while to take in lots of information and make sense of it.  I like to spend time alone a lot and its probably also why I enjoy writing so much.  It truly helps me to process complex ideas, loads of constant new information, and keep track of things I shouldn't forget (but likely would, if I hadn't written it down or kept a record of it in some way).  I understand not everyone is like this.  I notice a lot of people around me are able to move much faster.  They can have multiple social interactions in one day, while holding down a full time job, and managing a wide array of constant responsibilities while also processing a lot of complex, new information every day.  I wish I could do all of that, but I know I don't have the capacity to do all of that while I’m still maintaining my body and mind, which is why I don't engage with the same lifestyles or life goals as they do.  It does bum me out sometimes - like when I see old friends meeting all the classic milestones of life such as having a career, starting a family, or owning a home.  I do wish I could do all that, but I know I simply can't keep up with that, so I abstain from it.

When I am overstimulated, stressed out, confused, or anxious, I cannot keep up with my diabetes.  I forget all the tasks at hand.  I will reach for a piece of food and just eat it.  But here is why a constant state of overwhelm is dangerous for a person with T1D.  We really do have to eat "differently" among many other things (including stress management).  These requirements also vary depending on what devices you are using for diabetic management, what your material resources are, how you go about your day, ETC.  For example: I need to eat 3 meals each day, spaced out by about 5 hours.  Before eating or drinking something with carbs, I first have to check my blood sugar level (I currently use a CGM for that, but my back up is a finger-prick based glucose meter).  Then, I have to decide what and how much I am going to eat.  You can't eat less or more than what you decide.  That is because, based on your blood sugar level at that time and the carb count of your meal, you have to then calculate an appropriate dose of insulin to inject yourself with.  Then, you inject your fast acting insulin (not to be confused with long acting insulin which you take once a day in addition to that).  Then, you wait 20 minutes.  Then you can eat.  But you can't eat less than what you counted for (because you will then have too much insulin in your blood and will get a low blood sugar) and you can't eat more than what you counted for (because then you will get a high blood sugar).  When I am calm, at ease, and thinking logically and rationally - yes, I can absolutely do all of that and in the correct order.  But when I am not, which can be a constant state spanning long periods of time, I absolutely cannot process nor execute all of those tasks, three times a day, every day.  I feel like I can’t follow this regimen on ANY day- it overwhelms me too much. This is why its easier to be alone most of the time.  Its probably why I love my job being a dogwalker - I can keep my own schedule, go at my own pace, and meet my needs as they arise.  It doesn't require too many awkward social interactions - dogs are pretty straight forward.  I know what tasks need to be completed and for how long, etc.  The simplicity of the job suits me, and I do require that simplicity to complete all my other daily tasks.  I've had family members criticize me for being a dog walker, saying I wasn't realizing my full potential or that I had low self-worth and that's why I didn't go after more "challenging" jobs.  I just have to ignore that kind of stuff now, because I know what my needs are in that realm (job world) and I am simply trying to accommodate them in my daily life.  That is a necessity when part of my daily life is being constantly overwhelmed by my body and brain - just existing on a very basic level is a lot of work already to me.  Again, for some people, that is not too much work.  But my slow-paced and very LOUD brain coupled with my demanding physical body makes it too much work for me.

I know one helpful action item would be to get back on an insulin pump, because it changes the rules a tiny bit.  For example, the reason I have to only stick to three meals a day spaced out by 5 hours is to prevent insulin stacking.  You have to make sure one dose of insulin has run it's course through your blood before you add another in there.  If you don't, you run the risk of hypoglycemia (low blood sugar event).  I've interacted with people who aren't diabetic who have said "Oh yea, I get low blood sugar all the time!".  I'm sure they do, but these events are not the same.  Feeling faint because you haven't eaten is one thing.  Feeling faint and passing out because you injected yourself with too much insulin is a whole different monster.  It made me crash my car one time, and that event really sucked! It also broke my heart, because a stranger approached me in the car to make sure I was ok.  I tried to communicate to them that I was having a low blood sugar and needed glucose immediately.  But I could not communicate this to them because of the severe low.  They assumed I was fucked up on drugs or alcohol, dismissed me, and walked away.  I still don't think I'm done processing that event, nor others like it, because those take a long time for slowLOUD brain.  When you have an insulin pump - you are tethered to a continuous, steady stream of insulin.  This means the 5 hour rule for meal spacing doesn't apply.  It also means the 20 minute rule before eating doesn't apply.  You get to be just a little closer to a "normal" human than not.  

I've been on a pump before, so why am I not now?  Because of ALL THE OVERWHELMING reasons in slowLOUD brain.  I bet if brain didn't get in the way, I could probably manage life with two medical devices better.  But I am already overwhelmed by the constant data emitted from my CGM (blood glucose monitoring device).  This was a conversation I had to have with my endocrinologist.  One reason why doctors are reluctant to prescribe a patient a CGM is because they worry about "information overload".  That is why they are cautious about pushing devices on people who present as anxiously as myself.  When I was on an insulin pump, I struggled with it.  It was constantly beeping at me with its needs, just the same as my CGM does.  You had to change it every 3 days.  You had to keep back up supplies on you at all times, in case it failed, which is a scary event.  One time when I was on the pump, I went to a friend's bachelorette party in the middle of the woods.  I didn't know it at first, but my pump had a kink in it.  So it appeared to be working, I kept telling it to inject me with insulin, but my blood sugars just kept skyrocketing quickly.  I started vomitting and exhibiting signs of entering DKA, a complication that leads to coma and death.  This whole event was scarier, because I was at an overnight party and far away from home, and I also didn't want to ruin the nice time by telling everyone what was going on with me.  I decided that even though the pump appeared to be working, it clearly wasn't.  When I finally took it off, I saw the needle was bent.  So yes, the insulin was coming out, but it wasn't entering my blood because of the bent cannula.  Luckily, I had a spare, and replaced it.  But I was still very sick the rest of the night and the next day and it took a long time to get my blood sugars back to a safe level.  The reason you can enter DKA so quickly on a pump but not on manual pen injections is because when you take pen injections, you take a secondary insulin, called long-acting insulin.  When you're on a pump, you only take rapid acting insulin, because you are constantly tethered to it.  Maybe some people are OK with the precarity of that trade off, but I don't think I am.  That is too much anxiety for slowLOUD brain to hold.  There are other reasons too - I don't like a large, heavy devices hanging off my body - it feels weird and distracting and uncomfortable.  It gets caught on stuff constantly.  My health insurance sucks - so I can't guarantee that my back-ups will have back-ups when technology inevitably fails.  All of that is too much precarity for me.  Since I know having two medical devices to keep track of overwhelms me like that - I decide to just stick with my CGM, which is already a constant pain in the ass to acquire and its own monster to do a daily battle with.

I think the TLDR version of this entire post would be: OVERWHELM IS REAL.

I have so much more to say about this, I'm sure every diabetic would.  I will maybe make a series of "diabetic rant" posts, because it really is too much for brain to hold and it is something that I wish nondiabetics were more aware of.