This month I marked 30 years of living with type 1 diabetes. Collectively, my family has 55 years of experience with T1D between myself and my relative. In the past, I would have calculated and best-guesstimated the hundreds of thousands of needle pokes incurred over these diabetes years. So much of our time is spent analyzing numbers and trying to find meaning in it all.

My 30th diaversary, however, was mostly met with ambivalence on my part. When a friend texted me to be kind about this milestone of an anniversary, I replied succinctly, “Thanks. Honestly, today has just been another day. And I’m okay with that.”

This is not to say that I’m burnt out, or ungrateful, or anything else negative and patient-blaming which healthcare so often unjustly engages in. Rather, quite the opposite. I was ambivalent simply because my interests have shifted over time, and diabetes no longer takes up the bandwidth that it once did in my mind. I still struggle and suffer from the nonstop burden of diabetes management as complicated by many external barriers to care. But it’s more of a rolling with the punches experience now, rather than constantly lacing up my gloves for another round. There is peace to be found in the rhythm of acceptance, and moving towards what I value no matter what.

I also recognize the great juxtapositions here:

30 years of diabetes is a huge deal defining decades of strength and resilience. We should celebrate those achievements and express thankfulness for our supporters.

But we should also acknowledge that none of this is fair. The dial hasn’t moved on diabetes-land in the ways that we need for every person with diabetes, everywhere, to have good quality of life. We still need a cure. We still need better insulin treatments, and we absolutely need these options to be readily accessible and affordable for everyone. No more jumping through hoops; just commonsensical, “Can I quickly access what I need to live well even at 3:43 am in a snowstorm?” sort of standards of care. We’re unfortunately still far from these equitable meters of QoL.

It is not lost on me that many people do not get a chance to write a 30th diaversary blog post as they may have hoped. Factors such as missed or delayed diagnoses fueled by societal stigma and misunderstanding of diabetes; the inextricably intertwined challenges of emotional health and chronic disease; effects of socioeconomics, race, class, gender, education, environment, war or peace, and much more; and, most pressingly, global access to insulin / insulin pricing all weigh heavily on my heart today. Those who have died slowly and painfully from DKA, particularly, remind me that even though ambivalence at 30 years of surviving an unrelenting disease is acceptable, my own years cannot be in vain. My story could have begun and ended differently. Others were not so fortunate, and our advocacy must honor them.

Despite the daily challenges posed by diabetes, I am still here, through hard work, yes- but also through lots of luck and privilege. We are allowed to be cognizant of each of these contributors to diabetes care, to be proud and happy when we feel well and achieve our goals, while simultaneously mourning the support we lack personally and universally in our diabetes care trajectories.

I feel all of that today.