Sarah Butters
St. Mary’s College of Maryland
Sarah was diagnosed with T1D when she was 2 years old. In the 23 years between then and now she has discovered her passion for theater, graduated from St. Mary’s College of Maryland, and entered the museum field. She continues to educate herself about her own diabetic experience and seeks to educate those around her.
What does “safe sex” mean for someone with type 1 diabetes? For the most part, safe sex looks the same for someone with diabetes as it does for anyone else. But there are other things I wish I had heard when I got “the talk.” Getting advice on STIs, pregnancy and protection was great- and useful. Now I want to share some of the things I would’ve benefitted from hearing when I was younger, that I had to learn myself.
Look. If I had complete control of my blood sugar at all times, I wouldn’t be diabetic. Things happen. Blood sugar drops or spikes. If you use an insulin pump and choose to disconnect from it during sex, you could be without insulin for a while. That’s not necessarily dangerous, if you do it right. I choose to remove my insulin pump during sex, and in my experience, since sex is a physical activity, I don’t find that my blood sugar rises dramatically, if at all. But of course everyone is different. Staying on top of your blood sugar throughout the day helps to avoid complications during sexual activity. If your insulin pump has an “exercise” setting, or you and your doctor have agreed on a temporary basal rate for physical activity, putting this in motion about an hour beforehand helps to prepare your body for sexual activity. Taking preventative measures by setting temporary basal rates early will feel better than trying to chase a low with lots of sugar, and potentially overtreating. High blood sugar can make you feel awful, which will kill your mood as much as low blood sugar will.
“I used to have a lot of shame about being a sexual partner with medical devices. So I understand the emotional burden and intimacy issues that can come with living with diabetes.”
Safe sex isn’t only about physical health. Every sexually active person deserves a partner they feel safe with. I used to have a lot of shame about being a sexual partner with medical devices. So I understand the emotional burden and intimacy issues that can come with living with diabetes. Letting a person see the things that are attached to you, like a CGM or a pump site, can feel strange. I used to have a lot of insecurity about it, and I avoided wearing the Dexcom for a long time because of it, even though my Dexcom is so important to me now. I didn’t want to have to explain it to people. Before I met my boyfriend I was being intimate with people I didn’t really discuss my diabetes with. That could have been dangerous for me. If I was in a situation where I was incapable of taking care of myself, they would not have known how to help me. In those situations I would disconnect my insulin pump as discreetly as possible and put it somewhere where it wasn’t visible. I felt like my pump was a turn-off. But do not waste a second on anyone who intentionally makes you feel weird about any of the medical devices that you use. It is there to keep you alive and well, and anyone who cares about you will respect that. And if they’re not respectful of your needs, could they be relied on to take care of you in an emergency? In any situation where you don’t want to continue (because of diabetes, or for any reason) you need a partner who understands consent, and respects when you say “no” or “stop.” And sometimes you will have to stop– as I said, we can’t have complete control of our blood sugar. I’m lucky to have a wonderful partner now who I can trust.
“In any situation where you don’t want to continue (because of diabetes, or for any reason) you need a partner who understands consent, and respects when you say “no” or “stop.””
Early on in our relationship, low blood sugar hit me like a ton of bricks when we were (to be very frank) already having sex. I felt terrible. I felt lightheaded and completely disoriented. I remember sinking to the floor looking dazed, and he noticed right away that something was wrong. Once he had helped me to start bringing my blood sugar back up, the shame started to creep in. I had never wanted my diabetes to get in the way of my sex life, and I had been lucky that it hadn’t up until that point. I apologized again and again. He told me I had nothing to be sorry for. It took me a little while to realize it, but he was right. I may embarrass him when I say this, but no one should be settling for anything less than what he does for me. Diabetes is not shameful. Your needs, especially in an incredibly vulnerable situation, are valid. And anyone you have to hide a part of yourself from is not worth your time. Be safe, be happy, be completely yourself.
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