The Demand of Type 1 Diabetes on Autistic Individuals

Managing type 1 diabetes is challenging for anyone, but for autistic individuals, especially those with Pathological Demand Avoidance (PDA)—it can feel overwhelming. The constant routines of monitoring blood sugar, administering insulin, attending medical appointments, and managing diet can clash with sensory sensitivities, emotional needs, and a desire for autonomy.

The pokes and prods

Constant blood tests and check-ups with healthcare providers can create additional stress. The expectation of attending medical appointments is already greatly increased for neurodivergent individuals, and being a diabetic just adds more doctors visits. These visits are often focused on intense analysis of the individual’s diet, exercise regime and suggestion to modify behaviours to adjust Hb1Acs*. Even a positive medical visit will still leave the patient with homework and feedback.

Adding in the basic maintenance of being a diabetic, such as considerations for needle disposal, sensor application, ensuring the sensor is synced correctly, adjusting your movement so you don’t bump your sensor, it’s so emotionally taxing.

A full time job

For neurotypical individuals, managing type 1 diabetes can feel like a full-time job. The constant need to monitor blood sugar levels, calculate carbohydrate intake, and administer insulin injections leaves little room for spontaneity.

For autistic individuals, especially those with PDA, this structured demand can be overwhelming. The need to adhere to a rigid routine, especially one that feels imposed rather than chosen, can exacerbate feelings of anxiety, frustration and loss of autonomy.

Dietary changes and the challenge of safe foods

Diet plays a critical role in diabetes management, but for autistic individuals with sensory sensitivities or a strong preference for certain foods, these dietary changes can be difficult.

Foods that are often staples and safe foods for individuals—like pasta, chicken nuggets, chips etc— come with the need for a higher dose of insulin and therefore yet another carb that needs to be counted. This struggle can feel like another demand imposed upon them, which can complicate their relationship with food.

Unwanted Social Interactions

Dealing with unwanted attention, forced to be social when you don’t want to be social, are moments that both neurodivergents and Type 1 diabetics experience on a regular basis.

From personal experience, the sensor on my arm has instigated lots of scrutiny and interest, and many strangers have engaged in invasive questions about my sensor when I’m trying to do day to day things like grocery shopping.

When I introduce myself, I feel like I need to disclose my diagnosis in order to ensure I don’t offend or worry someone if my sensor goes off and I need to adjust my levels.

What can people do to support those with Type 1 Diabetes?

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