Professor Nick Agar on why he hid his diabetes until now 14 July 2021 By Professor Nick Agar – Professor of Ethics, Victoria University of Wellington Some medical conditions are visible for all to see. Others can easily be concealed. For much of my life I concealed my Type 1 Diabetes. I knew little about diabetes when I was diagnosed at age 25 after experiencing intense thirst and peeing a lot – in medical parlance, polydipsia and polyuria. I remembered my mother pointing out a child with diabetes at my school observing that he was “doped up to the eyeballs on insulin”. That sounded frightening. That’s basically the only time I thought about the condition until I was diagnosed. I was determined that this news shouldn’t go beyond family and medical professionals. After all I looked normal. When out at dinner I’d sneak off to the toilet to jab up and no one was the wiser. I had another reason to keep quiet about my disease. I was an aspiring academic following my dream to lecture in philosophy. People with type 1 diabetes sometimes experience hypoglycemia – low blood sugar. When that happens to me I find thinking straight a challenge. I can be in the middle of a conversation and notice that not much of what people are saying makes sense anymore. I learned to think – this must be a hypo! – and promptly consume a sugary drink. According to a recent survey, I’m not alone in this fear. 49% of people with type 1 diabetes feel embarrassed about what people might think if they have a hypo. As a young academic I really didn’t want potential employers to know about a medical condition that might send me abruptly gaga mid lecture, so I never told them. The good news is that in 25 years of teaching this has yet to happen to me. So why am I talking about my medical condition now? The more people who hear about the experiences of people with diabetes the better it is for us. When people hide medical conditions, damaging myths spring up around them. People with diabetes need something of the revolution in thinking that is happening now in mental health. You can see why people would want to hide a diagnosis of depression – according to a popular but pejorative myth depressed people aren’t great company. Now we see loads of successful people talking about their struggles with depression. I suspect few would turn down the opportunity to hang with Lady Gaga or Bruce Springsteen. Among all the many curses of social media it has also given people the opportunity to speak candidly about their experiences of conditions like diabetes and depression. More of us need to speak sincerely and share our stories. Diabetes is a significant feature of my life. When I write about my diabetes, I’m certainly not Facebook bragging. But I do nevertheless enjoy telling people about my experiences. When people with diabetes are visible, we can become not people with a condition but people in need of support and understanding. The more we hear from people with diabetes the greater the pressure it will place on government to also properly fund the technologies we need to live long, healthy lives and reduce the cost of diabetes related complications on the economy. Continuous Glucose Monitoring (CGM) devices monitor blood glucose and instantly warn people when glucose levels go dangerously low. It is life changing technology as it means no more finger pricking and manual testing. However, CGM’s are only subsidised for people under the age of 21. The rest of us are left to pay the hefty tab of up to $5000 a year for a CGM, with very few Australian insurance schemes covering the devices. If people with diabetes have free or subsidised access to advanced technology, it significantly reduces the risk of health complications. By providing access to CGM’s it reduces the future expense to the Australian taxpayer of dealing with complications. But it’s hard to persuade governments to spend money now when they can just do nothing and let the government in 20 years’ pick up the tab for complications of diabetes such as blindness or kidney failure. The more we hear from people with diabetes the greater the pressure there should be for government to fund the technologies we need to live long, healthy lives, and to contribute to Australia’s economy.