Remember that popular Beatles’ song, “When I’m 64?” The refrain goes, “Will you still need me, will you still feed me, when I’m 64?” I often wonder how I’ll be able to manage my diabetes when I’m old. Granted I’m 56 and many would say I’m already old, but let’s not go there.

But ’tis true, my memory isn’t what it used to be. Sometimes in the morning, since I take three injections, I can lose sight of which I’ve taken and which I haven’t. I begin with an initial unit of Apidra (rapid-acting insulin) when I first wake up to blunt my rising blood sugar (dawn phenomena). I take my breakfast bolus once my bowl of oatmeal is already in my lap – sorry, small one bedroom apartment means my dining table supports my computer, not my meals. 

I try to take my Lantus (long-acting insulin) around 8:30 AM, but sometimes I’m just not entirely sure whether Lantus made it into the mix, in-between the testing my blood sugar, throwing the oats in the pot, stirring, checking the weather, sifting through my new emails, deciding what to where and when to shower. 

The way I can usually remember whether I took my Lantus is to try and find the red mark on my body where I injected. Is it on my thigh, near my navel, on my upper arm? If I can remember where I injected, then I know whether I’ve injected. Hmmm…doesn’t inspire great confidence, does it?

What will happen as my eyesight worsens? I’ve worn glasses since the age of eleven, but what if it gets worse? Will I be able to see the notches on the syringe? True, by then I’ll be bionic sporting a pump, CGM, artificial pancreas, the whole nine yards, and likely the cataract surgery I’ll need soon may even restore my eyesight. OK, forget that one.

But what about Alzheimer’s? How do people with Alzheimer’s and diabetes remember to take their medicine? Order their refills? Schedule doctor visits? How do people with Parkinson’s and diabetes keep from trembling during an injection or pump bolus? Really, how?

Managing diabetes as a fairly healthy adult who works at home and so can tailor her day around her diabetes needs is laborious, but entirely doable. What will it be like, however, in ten or twenty years when my knees are shot so I can’t stand well and reach my insulin in the fridge, my memory’s gone so I haven’t a clue if I shot up or even what I take anymore, the dribbling starts and I slip in the tub…yikes!

All this makes me ruminate that this is not an illness for the aged and yet of course it’s mostly seniors who get diabetes. I don’t know the answers to how I’ll manage this when I’m 84 (at least I’m thinking that far out) so I choose not to spend much time in the question. And I do expect by time I’m “old” so much will have changed to manage diabetes that there’ll be hardly much at all to do. 

Doesn’t hurt to dream, does it?