While volunteering in Nepal, I was diagnosed with type 1 diabetes at age 31. It was Valentine's Day 2014, and my wife and I were in the middle of a backpacking trip around the globe. We had just finished a hiking trip in the Himalayas that almost killed me.
I had been losing weight and had to run to the bathroom constantly. And I had never in my life been so thirsty. I dismissed the symptoms as consequences of the dry weather, until I stepped on a scale and saw how much weight I'd lost: about 40 pounds.
A trip to a local doctor gave me the diagnosis that would change my life and land me in two hospitals in Nepal before I was cleared to fly home. I spent a month learning about diabetes and understanding the ins and outs of a chronic autoimmune disease. Then it was time to make my decision.
My wife, Cassandra Kramer, and I resolved to get back on the road and finish what we had started. I knew that if I accepted limitations so early in my life with diabetes, I would always accept limitations, and that was a dangerous state of mind.
We caught a flight to Bangkok and made our way through Southeast Asia, South America and Iceland before coming home.
One of the fastest-growing diseases
Diabetes is a disease with which the body no longer produces enough insulin to regulate blood sugar. In type 1 diabetes, the pancreas stops producing insulin altogether, requiring daily injections of artificial insulin and constant blood sugar monitoring. In type 2 diabetes, the body's insulin isn't used effectively, which is sometimes the consequence of being overweight. Type 2 diabetes can require some combination of lifestyle change, medication and insulin injections.
Diabetes is one of the fastest-growing diseases in the United States, with 1.4 million Americans diagnosed every year
. Nationwide, 29 million Americans have diabetes -- nearly 10% of the population. Worldwide, 415 million people have it. That number is expected to reach 642 million by 2040
Yet the cause of diabetes is unknown. Although some cases of type 2 may be a result of obesity, that answer does not apply to everyone, and there are no such clues for type 1.
Diabetes still has a stigma attached to it, largely because of a lack of education and awareness. But people are constantly defying it by showing that there is no reason to accept limitations or boundaries when living with diabetes.
It may require more planning, but it's not a reason to say "no" to any experience.
Will Cross was diagnosed at the age of 9 in 1976, when diabetes care was nowhere near what it is today. He became the first person with type 1 diabetes to summit Everest when he scaled the highest peak in the world in 2006. He has also climbed the Seven Summits -- the highest peak on each continent -- and traveled to the North and South Poles.
"I never aspired to be a baseball or football player," Cross told Beyond Type 1, an organization dedicated to living with type 1 diabetes. "I just wanted to climb; diabetes didn't hinder that desire."
One person who did want to play football was Jay Cutler. The former quarterback for the Chicago Bears was 24 when he was diagnosed, making him one of a small but growing number of people with type 1 diabetes diagnosed after puberty. (Type 1 diabetes was traditionally called juvenile diabetes, but that term is becoming outmoded as the number of adults diagnosed with type 1 diabetes increases, though researchers don't fully understand why.) Cutler went on to play nine more seasons in the NFL, and he has become one of the best-known athletes with diabetes but certainly not the only one.
Perhaps the most famous celebrity with diabetes was Mary Tyler Moore, who used her fame to advocate for people with diabetes. Moore served as the international chairman of the Juvenile Diabetes Research Foundation. Her death in January sent shockwaves through diabetes community, which had lost one of its biggest influencers.
And if you're looking for a celebrity to pick up where Moore left off, singer Nick Jonas has carried the mantle so far, founding Beyond Type 1 and being candid about dealing with diabetes.
"It is very easy to want to hide what diabetes means for us in the workplace, but that just does a disservice to us, to other people with diabetes and to our coworkers," adventure athlete Erin Spineto said.
Diagnosed with type 1 diabetes in college, Spineto has completed a 100-mile standup paddling trip and sailed the Florida Keys solo, all the while proving that anything is possible, despite the disease. "The more real information and firsthand experience people get with this disease, the less stigma will be attached to it."
Making diabetes work for you
I was able to use my diabetes diagnosis, in a way, to improve my health. Though I have a chronic disease that requires constant blood sugar checks and insulin injections each day, I also have the most powerful of reasons to eat healthy, exercise and take better care of myself: a functional life.
Failure to stay healthy and keep my blood sugars in check can lead to the severe complications of diabetes: nerve damage, eye damage, cardiovascular disease and much more. Regular exercise and healthy eating help regulate blood sugar levels in people with diabetes.
Diabetes was the catalyst for that change, even if it means I am now walking around with a medical time bomb waiting for me to make a mistake.
Perhaps the most frustrating part about diabetes is the lack of definitive answers. Questions such as "how did I get it?" or "will there ever be a cure?" must remain open-ended for now. Although there are procedures that show promise for reducing or eliminating the need for insulin and an artificial pancreas (a device that manages blood sugar automatically) is on the horizon, a true cure for diabetes remains elusive. The same is true for understanding the cause.
Yet it is a manageable disease. With experience, discipline and a support network, diabetes should never be a reason to say "no." It's just a matter of figuring out what preparations you need to make to be able to say "yes."
Since finishing our backpacking trip, my wife and I have continued to travel when we can. Hiking Kilimanjaro is high on our priority list, and I want to return to the Himalayas to hike once again, this time knowing how to treat my diabetes.
For me, it is an extension of the most important decision I have ever made: the decision to live life without limits.
Maybe I'll even climb Everest.