A couple months ago, I was contacted by someone from Diabetes Forecast magazine, part of the American Diabetes Association, asking if I would be willing to answer a few questions about dating, relationships, intimacy, and sex with diabetes for an upcoming article. I gave this request a lot of consideration, since these are sensitive topics that I have tended to steer away from on my blog. Ultimately, these are important, real life issues that people with diabetes wonder about, but are rarely talked about. I decided that I have a perspective that is worth sharing and I hope that it will help others who may have questions or concerns related to these topics.

The article “Sex and Diabetes” in Diabetes Forecast does a really good job of talking to a diverse group of people with both type 1 and type 2 diabetes, and sharing their varied experiences. It combines their stories with important and relevant information from medical professionals. I highly recommend you read it. I have 2 quotes in the article, which were part of a much longer interview. I have decided to post the full interview below.

How and when do you reveal that you have diabetes to a partner or potential partner?

My diabetes is a big part of my life, and it’s important that I’m with someone who is understanding and supportive. If they’re not, I’d want to know upfront before things get too serious. I usually tell someone I have diabetes on the first or second date. I’ve always found ways to naturally bring it up in conversation. For example, when discussing hobbies or interests, I talk about my blogging. Since my blog is about living with type 1 diabetes, it has become a perfect opportunity to approach the subject.

How big of a deal did or do you make it?

My diabetes is always there; I’m always thinking about it and managing it. But I’m so much more than my diabetes, it’s just one small part of who I am and part of the package. Although not quite the same, I relate it to someone telling me they’re gluten free or they have a cat (I’m allergic). It’s part of who they are and if you choose to date them, you’re accepting what that person brings to the relationship. For me, it’s a chronic condition. But I’ve also been managing my diabetes for many years now. I’m not looking for a doctor or someone to fine tune the intricate details of managing my diabetes. I’m looking for someone who will be there with me through the ups and downs.

How much of your diabetes do you reveal to them?

I’m very open about my diabetes, especially with blogging about it. I enjoy talking and educating people about type 1 diabetes. So in the beginning of dating or a relationship, it’s mostly the basics: what is type 1 diabetes, how long have I had it, and the what it means to manage it. I’m always willing to answer questions. It shows me the person is engaged and eager to learn, which I appreciate. Over time as I get to know someone and feel more comfortable, I open up more about the emotional and personal aspects of living with type 1 diabetes.

How can you be open and honest, while still keeping personal any health issues that you don’t feel comfortable sharing?

Open communication is important in any relationship. It’s up to you how much you feel comfortable sharing, when, and with whom. And the other person should understand and respect your decision to share or not. I’ve said things like, “I’ll tell you more about that later” or “I don’t really want to talk about that right now.” Ideally, you’re with a person who eventually you do feel comfortable sharing things with, but you should never feel pressured to do so until you feel ready.

Has talking about your diabetes ever upped the emotional intimacy in a relationship?

I think talking about diabetes can have the potential to up the emotional intimacy in a relationship, but it probably depends on the person. You are talking about a personal health issue and if you’re someone who keeps things to themselves, sharing this can be a big deal. For me, talking about my diabetes and what it means for my future, like pregnancy or fears of complications, have led to more intimate and serious conversations. But these are also important conversations that I’m glad I had that brought up non-diabetes related topics as well.

Do you wear a pump?

Yes

Do you take it off during sex?

I don’t have any hard and fast rules. The CGM is very useful, I’ll definitely check my blood sugar on my CGM before disconnecting. If I feel like my blood sugar is in a good place that I can disconnect for a little while, I will. But if not, I’ll keep it connected and just try to keep my pump out of the way. If my blood sugar is dropping or relatively low, I might take a few fruit snacks to avoid the disruption of a low later. But mostly I just go with the flow. Yes, there may be some awkwardness, some cord tangling for example, but when you’re comfortable with the person you’re with, these things aren’t a big deal.

Do you wear a CGM?

Yes

Has the CGM ever come in handy to warn you of lows during sex?

The CGM is a great tool to see how my blood sugar is trending. It’s useful to help anticipate lows before they happen and become disruptive. I usually can feel my lows before my CGM, but the persistent, rather annoying, low alarms definitely do their job of making you stop what you’re doing so you can take care of yourself.

Do you take other precautions during sex? For instance, do you keep a stash of glucose tabs by your bedside?

I’m always prepared for a low blood sugar no matter what I’m doing, but especially if I’m doing something that has the potential to drop my blood sugar. I use fruit snacks to treat a low and basically always have them within reach if necessary. I wouldn’t say I take too many other precautions.

Do you have to plan for sex, or can it be spontaneous?

When you live with diabetes, you learn to always be prepared for anything in any situation. To me, there’s not much of a difference in terms of my diabetes between a spontaneous bike ride or sex. In either situation, you need to be prepared for high or low blood sugars and everything in between.

What are some of the mental aspects of diabetes and sex?

Sometimes I feel a little guilty if we have to stop whatever we’re doing so I can treat a low and then have to wait for my blood sugar to feel normal again. Lows are disruptive, and even more annoying when you have to stop doing something you are enjoying. But I’ve also come to appreciate and enjoy the cuddling that usually happens while I wait for my blood sugar to rise, so even challenges can have a positive aspect too.

Is body image ever a factor?

I used to be more self-conscious about my scars from all my set changes and even the infusion sets and sensor that I wear, but now I don’t really think about them. Body image is complex and something I think people struggle with whether they have diabetes or not. My scars are reminders of how strong I am and how much I overcome each day living with diabetes. The devices I wear keep me alive and healthy and make managing my diabetes easier. I have my own insecurities like everyone else, but they’re not really related to my diabetes.