UNIVERSITY OF MINNESOTA PRESS, MARCH 2016One month after my sixteenth birthday in 1992, I was diagnosed with insulin-dependent (type 1) diabetes. For myself, and people with all types of diabetes, including type 2 diabetes and other forms of glucose intolerance, a diagnosis of diabetes means lifelong daily self-surveillance of blood sugar and the constant readjustment of treatment regimes, whether those regimes involve injecting synthetic forms of insulin, taking oral glucose-lowering agents, eating healthier foods, or exercising regularly. I often think about my life with diabetes as a kind of war, a conflict I fight on the terrain of my own biology with battlefronts along cellular walls, grocery store aisles, and the pharmacy checkout counter. My particular battle is with a biological marker called blood glucose, or blood sugar. Blood sugar is routinely measured in milligrams of glucose per diluted liter of blood plasma. Blood sugar is a universal biomarker for all forms of glucose metabolism; the ratio tells you how well or how poorly your body is processing the sugar you consume and the sugars that are converted from stored fat deposits in the body. I, like millions of Americans, struggle for survival within these political forces that aim to manipulate, control, and profit from the metabolic processes within my body. I have struggled within the politics of metabolism for twenty-two years as an African American man living with diabetes.
When I was first diagnosed in 1992, the self-surveillance blood sugar monitor I owned took a full two minutes to compute my blood sugar; the monitor I now use takes a lightning-fast five seconds to tell me my ratio. Having checked my own blood sugar on average at least four times a day every day, I have monitored my own blood sugar more than thirty thousand times. If I live to be sixty-five years old, and assuming I continue to have health insurance and therefore subsidized access to blood glucose monitors and the expensive testing strips, I will have checked my blood sugar more than seventy thousand times. Each strip costs about one dollar (retail). The daily self-surveillance of blood sugar can (and should) be ...
