Sara Lerner

3 Years with T1D: Learning to Love and Learn from my Lazy Pancreas

From a young age, I was enchanted by love stories. From fairytales to beach reads to rom-coms, I grew up dreaming of my happily ever after love story. The reality of the love story I’m sharing with you today is a little bit different. It began with the opposite of a meet-cute on June 7th, 2022 when I was hospitalized and diagnosed with type 1 diabetes (T1D) shortly after my 25th birthday. Some may refer to this as the definition of a quarterlife crisis.

Year 1: Adjusting to life with T1D

The following months were somewhat of a blur as I adapted to my new and fast-changing lifestyle. I learned how to treat highs and lows, I switched from multiple daily injections to an insulin pump, and I started to understand how different exercises, foods, and daily activities impacted my blood sugar. While I joke that I’m part robot or cyborg with my continuous glucose monitor and insulin pump attached to my body at all times, I couldn’t be more grateful for the privilege I’ve experienced with this condition and the technology I have that helps me manage my blood sugar 24/7.
As the youngest of four children, I was used to going with the flow. But with the added responsibility of having to actively keep myself alive every day through calculations of insulin-to-carb ratios and dosing and learning how different foods, exercises, hormones, and so many other factors affect my body, I had to learn to prioritize and advocate for myself and my needs. I have to think about every bite of food I eat—calculating the right dose of insulin, waiting 15 minutes for the insulin to start working (known as pre-bolusing), and then finally getting to enjoy my food. Sometimes I stay up late waiting for my blood sugar levels to stabilize, other times I’m woken up several times a night by alarms from my sensor telling me my levels are too high or too low. In my first year with diabetes, I pricked my finger over 500 times checking my levels, I gave myself over 480 injections of insulin before getting an insulin pump, changed my pump site 90 times, and changed my continuous glucose monitor sensor over 35 times.

With every poke and prick, I repeated a mantra to myself, “You are strong, you are brave, you are resilient.” Eventually, I started to believe it. While I had to make a lot of personal changes, I have also been blessed to have an amazing support system. I had family members and friends get to me within hours (minutes in some cases) of my diagnosis via physically sprinting to me and hopping on the next train and plane to New York. I have received outstanding care and support, got plugged into the NYC T1D Community immediately, and began training my dog Louie to be a medical alert service dog within weeks of my diagnosis. Being insulin dependent is filled with highs and lows, physically, and metaphorically speaking. I learned more about myself in one year living with diabetes than I had in any year prior. My family leaned in and my young nieces and nephews lovingly began to ask if I needed some of their snacks when they heard the beeping of my alarms. I became confident in my ability to care for myself and in knowing what my body does and does not need. I looked for the silver linings daily and felt nothing but lucky for the privileged experience I had with this disease.

T1D left me living a healthier lifestyle, making decisions to prioritize myself and my physical and emotional needs

and dreaming big about what difference I want to make in this world and within the intersection of T1D and social work. I ended my first year living with T1D by throwing a pancreas retirement party for my diaversary surrounded by friends with and without T1D, family, and Louie –and I started planning what was next for me as I further immersed myself in the T1D community.

Year 2: Service Dog Training & Working in the T1D Space

For those who know me, it is not a secret that Louie was the center of my universe from the moment he came into my life in December of 2020. Originally destined to be a therapy dog to support my work as a social worker, Louie pivoted to service dog training with my diagnosis. Before his specialized training, Louie taught me the power of routine, staying present, and unconditional love. As a diabetic alert dog, his responsibility grew immensely to alerting me to low and high blood sugars and keeping me safe. A dog’s nose has over 100 million sensory receptor sites compared to about 6 million in my own nasal cavity— the brilliance of their ability to smell changes in bodily functions had Louie alerting me 20-40 minutes before my continuous glucose monitor alarms of a hazardous rise or fall in my blood sugar. This advance notice and his ability to wake up from his own sleep to wake me up allowed me to prevent many dangerous situations–Louie saved me in more ways than I can count.
In my second year with diabetes I also took up running. I watched a friend with T1D heroically run a marathon, and thought, if she can do it, so can I. Having never run more than a few miles consecutively, I had my work cut out for me. T1D has taught me that I can do hard things, so I laced up my running shoes, grabbed Louie’s leash, and got started. In December, I signed up for a half marathon just a few months away in March with team JDRF (now known as Breakthrough T1D), convinced some family members and friends to join me, and put meaning behind my miles with a goal of raising $10,000 for type 1 diabetes research.
As I began training for the half marathon, I felt more settled in life with T1D and the toolkit I had developed with the support from so many. I had known since my diagnosis that I wanted to work in the diabetes space professionally, and a month into my running journey in January 2024, I applied for a job with Blue Circle Health–an nonprofit organization funded by the Helmsley Charitable Trust with a free clinical care, education and support program for adults with T1D. On March 17th, I crossed the finish line for my first half marathon with an entirely new level of confidence surrounding my diabetes care. The next day, I began working at Blue Circle Health and entered the T1D space professionally–feeling so deeply connected to the mission. I closed out year two with diabetes just a few months later at an all team work retreat. Surrounded by my new work team, I felt energized and eager to dive deeper into the T1D world and do my part in helping others living with this condition.

Year 3: Running, Heartbreak, and Resilience

Shortly after running 13.1 miles, I decided my running journey wasn’t complete and I signed up for the NYC Marathon with the Beyond Type 1 Team. A lot
of people make assumptions when you live with a chronic condition about what you can and can’t do, and with a goal of raising $26,200 for Beyond Type 1’s health equity program–Beyond Barriers Program, I was determined to not just run the marathon and fundraise for a cause very close to my heart, but to also show that this condition doesn’t need to stop you from doing anything that you want to.

I still believe deeply that you can do anything with T1D that you set your mind to

but I learned the hard way that you can’t run a marathon with a broken leg. Just a few weeks before the race after a 20 mile run, my leg gave out and I broke my tibia. However, through running over 400 miles in training with 9 runs over the half marathon distance, I learned so much about managing my blood sugar in challenging situations, trusting myself more and relying less on technology, and I exceeded my fundraising goal for the Beyond Type 1 Team. While I was crushed to not make it to race day, life was quickly put in perspective when the day after I broke my leg, my best childhood friend passed away living with a rare form of cancer for many years. Rachel was the brightest light and an inspiration on how to find joy, gratitude, and be brave amidst health challenges. With Louie by my side, I found strength as I crutched through the next several months with an extremely heavy heart. The beginning of 2025 was busy with work and recovering from my injury. Unfortunately, on February 26th, life took another tragic turn when I unexpectedly lost Louie, my best friend and other half, after a very sudden onset of aspiration pneumonia, complicated by an unknown underlying heart condition. Louie was just 4.5 years old, but in his far too short life, he made more of an impact than many people do in a lifetime. He was the perfect mix of goofy, loving, and brilliant, and everyone he interacted with was infatuated. He showed me the utmost devotion, and caring for him in return was the greatest honor of my life. Louie and I were a team, and in an instant, every part of my daily routine and my relationship to my diabetes changed. But like with the other challenges I had faced in the months and years prior–and with an incredible community surrounding me with love and support–I took the lessons I learned from Louie, life with diabetes, and Rachel and put one foot in front of the other. Louie left the most beautiful legacy, but to further his impact I started a diabetic alert dog scholarship fund in his honor with Medi-Dogs Training. The fund has already raised over $25,000 and Louie has helped three families find their other halves.

Year three with diabetes was not a walk in the park. Despite many great moments, it was filled with a whole lot of loss, grief, and new challenges. After rehabbing my leg for 5 months, I embarked on a dream trip to Patagonia that had been two years in the making and hiked over 50 miles in just over a week. Carrying with me the losses from the year and finding strength in community, I was able to reflect on what my body was still able to accomplish. After living with T1D for three years, I now can’t imagine what my life would look like without it.

While there are days I may get frustrated or even angry, I find myself more grateful for what it’s given me than for what it’s taken from me. I’m thankful for the amazing people it’s brought into my life who give me hope and inspire me, for the adventures I had with Louie while he was still by my side, and for the work that I get to do every day with Blue Circle Health. I’m confident that I have a lot more to learn from life with T1D, and I look forward to all that’s to come. While it isn’t the fairytale love story that I expected to start at age 25, three years later I have learned to love my lazy pancreas and all that it’s taught me.