In a job interview, I could describe myself as “resilient”, “adept at multitasking”, and “highly organised”. What is yet to be a LinkedIn badge is actually my most developed competency: running a 24/7 biological systems management operation from my jeans pocket, with death as the price for quitting. Oxford is my day job. The other one never clocks off.
There is a particular cruelty in being an English student whose life is governed entirely by numbers. Being a Type 1 diabetic at university is, in essence, a double degree. One in your chosen subject, one in Applied Medicine. I might spend my morning attempting to decipher Middle English poetry, but my brain is simultaneously occupied with a far more urgent set of metrics:
6.8 and steady. 4.2 and dropping. 15.0 and climbing, ISF, HbA1C, mmol/L, IOB.
The inner monologue never stops. This is the part that is genuinely difficult to convey to anyone whose pancreas has the basic professional decency to show up for work. Every single decision: every walk, every meal, every night out, every lecture, is a variable in an equation I have to solve in real time.
Before I leave my accommodation in the morning, a complex algorithm is already running. I wake up and immediately “pre-bolus” (dosing insulin before I’ve dragged my half-asleep body to the kitchen) because the mere act of leaving my bed causes my blood sugar to spike. Then comes the mental mapping; how far am I walking? Long enough to require exercise mode on my device? How much sleep did I get? Not much if my glucose alarms woke me up. Did I over-correct? Do I need less insulin now, or more if I’m sitting in the library? Is my blood sugar too high to eat lunch right now? Too low to walk to class? Did I just take insulin, and now there is nowhere to sit and eat, leaving me stranded in a metabolic no-mans-land?
I’ll block out an afternoon to crank out an essay, only to realise I’ve miscalculated a dose. 18.0 and rising. My brain can’t focus, I stare at a blank work document, silently fuming that my own biology is sabotaging my education. 11pm rolls around, and I’m writing the essay that should have been completed hours ago. The frequent reminders that what is medically classed as a ‘disease’, or a ‘chronic illness’, is often precisely that. I am ill, I feel ill, and will be ill until the magic stem cells leave laboratory dreamland. “A cure is five years away” my paediatrician said, ten years ago.
Every three days, I perform the ritual of replacing the cannula that keeps me alive. The glucose sensor on my arm (has been mistaken for a nicotine patch, shoutout to the chef at my summer job for that innocent query) requires a mandatory 30 minute warm-up period after each change. 30 minutes chained to my room, waiting to be cleared for re-entry into regular human activity. I have learned to schedule this. I have learned to schedule everything.
I would also like to use this space to formally, publicly apologise to my tutor. There is nothing quite like a CGM sensor failure alarm, a sound engineered to rouse someone from the deepest unconscious state, detonating in the middle of a quiet discussion on the Enlightenment. Turns out diabetes does not care about the Enlightenment. There is something fitting about discussing thinkers who sought to master the human body as, three centuries later, so am I.
Socialising introduces an entirely new layer of chemical engineering. My thought process at the college bar feels more like a risk assessment than a carefree night of fun: What’s in that mixer? Is it sugar or sweetener? The liver processes alcohol before insulin, which means I’ll spike now and crash at 3am on the walk home. On the plus side, there is no antidote for hangxiety quite like the more critical relief of being able to look at my graph and see I’ve stuck the landing.
Here is what eleven years of this have taught me, beneath the dark comedy of it all.I am organised in a way I perhaps never would have been. There are 42 documented variables that can affect blood sugar, including stress, sleep, temperature, hydration, illness, and altitude. I am a self-aware “Type A” individual by necessity, not by nature. I plan compulsively. I carry backups of backups. I’ve had to explain to friends that it’s simply easier for me to wake up at the same time every day than to sleep until 1pm , because the beastly numbers on my phone prefer consistency.
I have also become a part-time educator to new acquaintances who spot the device in my pocket and receive my well-practised explanation: the difference between Type 1 and Type 2, “yes, I can eat that”, my immune system is simply a traitor. Finding other T1Ds at university has been a lifeline, people who understand that exam season is as much a medical management exercise as it is an intellectual one.
Chronic illness forces a kind of self-knowledge that is uncomfortable to acquire but genuinely helpful to have. I go about the struggles of Oxford life while actively keeping myself alive day in, day out, against a disease that would have been a death sentence had I been born a century ago. I often joke about my condition, but anyone living with chronic illness can take a step back and feel it’s pretty impressive to be not just surviving here, but thriving.
I sit writing this while a Type 1 Diabetes Barbie doll watches from my shelf: an Amazon impulse buy, but far more than a plastic children’s toy. The media reaction to her release told me everything I needed to know about how people might see and misjudge the devices on my body. It also reminded me that a decade ago, I was a ten-year-old who wanted to hide it all. Now I’m a 20 year-old who has concluded, reluctantly, that the disease has made me exactly who I am.
I would have preferred a functional pancreas. But I’ll take the essay crisis survival skills, the encyclopaedic knowledge of glycaemic indices, and the CV that doesn’t quite capture any of it.
