What David Marrero, PhD, remembers most about learning he had type 1 diabetes at the age of 25 were the can't-do's and never-mores. He assumed the disease meant a life of restriction -- no carefree eating, drinking, or random adventures.
Or so he thought. Times have changed, and most "absolute prohibitions" -- the don'ts -- are now do's, as long as you practice moderation, keep tabs on your blood sugar (also called glucose), and communicate with your doctor.
"I want to be able to indulge in the full richness of life. I can do that, but I have to apply some thinking and some rules to it," says Marrero, president of health care and education for the American Diabetes Association.
These are some things you may have thought were off limits, but aren't:
Sweets. You can eat the occasional candy bar, but figure out how much insulin you need, and then check your blood sugar in case the dose needs to be adjusted. When Marrero tries a new food, he checks his blood sugar every 30 minutes for about 3 hours after eating. Pay attention to your total carbohydrate load during a meal. That way, if you have something sweet, you can cut back on other carb-laden foods, such as bread or potatoes.
Alcohol. Have a beer, glass of wine, or cocktail with food, and drink it slowly. Be aware that alcohol can cause hypoglycemia, or dangerously low blood sugar, for up to 24 hours after you drink it. So check your blood sugar before, during, and after you drink, including before you go to bed.
Intense sports. People with type 1 diabetes have climbed Mount Everest, competed in the Ironman Triathlon, and run marathons. Marrero enjoys scuba diving, once considered too dangerous for someone with diabetes.
"Exercise acts like insulin and lowers your glucose," so you'll need to compensate, he says. For example, distance runners track their blood sugar to see how it fluctuates, and they use sports drinks, glucose gel, or another fast-acting carbohydrate to compensate.
Pregnancy. Work with your doctor to set up a pre-pregnancy plan and get your blood sugar tightly controlled before you conceive. High glucose levels can be dangerous for your baby, especially in the first trimester. Your target range before getting pregnant should be 60 to 119 mg/dL before meals and 100 to 149 mg/dL an hour after meals.
Jobs in transportation or law enforcement. Almost any job is open to people with diabetes. The Federal Aviation Administration still excludes people who are insulin-dependent from commercial pilot jobs, but you can apply for a medical certificate that allows you to fly private planes.
People with diabetes can become law-enforcement officers, though. Medical issues are handled on a case-by-case basis.
Ask Your Doctor
What are the symptoms of low blood sugar?
What should I know before I start a risky new activity, such as scuba diving or mountain climbing?
How often should I check my blood sugar when exercising or playing a sport?
Should I have a snack before I exercise?
How should I change my insulin treatment plan if I want to become pregnant?