On a summer evening in breezy Pune, Nupur Lalvani is out for her daily run. After a busy day of writing blogs and social media posts, arranging meet-ups and attending a 60-minute mixed martial arts class, this is the time and activity that she uses to relax and rejuvenate.
For the 31-year-old, a lifetime of type 1 diabetes management has also meant a lifetime of firsts and a routine built on discipline and purpose that drives everything she does. She's been fortunate, but she knows that not everyone affected by diabetes can say the same.
A few years back, she had an idea: What if there were a way to make diabetes conversations and resources available to anyone who might need them?
A Difficult Diagnosis
A few days before her third standards final examination, Lalvani found herself in the hospital. As she waited to learn the cause behind her persistent symptoms — constant thirst, irritation, fatigue — her mother brought her Enid Blyton books and her father pushed the doctors for an accurate diagnosis. Finally, one came: type 1 diabetes. She was 8 years old.
Maybe it was because of her age, but Lalvani remembers feeling OK — even indifferent.
"But it was a huge setback for my parents to realise that their child had been diagnosed with a condition that would require her to inject herself for the rest of her life," she said. "They were both crying, and I remember feeling guilty, thinking I had done something wrong."
Diagnosis was the first time things really changed. Because of her type 1 diabetes, Lalvani was treated differently during her childhood. Her parents kept a close watch on her as she took swimming lessons and partook in other activities. She was allowed to take special breaks during examinations so that she should grab a quick snack from her father, who would wait outside the classroom.
"I wanted to be a normal child," she said, "but it is only fair that they were worried about me."
She perceived the social stigma associated with diabetes when she was growing up, and still sees it today. As she got older, the daily injections were the least of her worries — she understood that she needed them to stay healthy. What was more important for her was being able to openly talk about her condition.
Lalvani never wanted diabetes to rule her life; she wanted to do all the things she would've done had she never been diagnosed. Inspired by her father, she began to run. She showed up to her first half marathon without any formal training and, incredibly, did fine, which she attributes to her generally active childhood. Soon, her entire family started coming along.
"Marathons were like family picnics for us," she said. "First, my father was involved, and then all of us started taking part."
"It was also around this time that Lalvani began to take her type 1 diabetes management more seriously. For a long time, she believed that managing her diabetes was someone else's problem, but taking ownership of her condition and well-being made her more determined, independent and clear-minded.
Improvements in diabetes management technology, too, made it easier for her to take control.
"Healthcare technology is like the cherry on the cake," she said.
In the 24 years that Lalvani has had type 1 diabetes, the technology around managing the disease has improved dramatically. Glucometers are extremely common now, but they were rare when Lalvani was a child. She used glucose strips to test her blood glucose and the method, at that time, only provided a range — not an exact number.
The first time Lalvani used a continuous glucose monitoring system, she could see the world of opportunity that the technology offered. The data it provided helped her better understand her condition, something she cites as a continuing game changer in diabetes management. And better management has given her the time and freedom for new pursuits. In addition to taking on martial arts, Lalvani was able to build on her marathon experience by competing in her first ultra-marathon.
Starting a Movement
Lalvani is quick to credit her family and the environment she grew up in with instilling in her the belief that nothing could stop her. But she couldn't shake the feeling that other people might not have it so good, that there might be children with diabetes who needed the kind of support she had — and who might be afraid to ask for it.
She co-founded Club 1 Diabetes with the aim of starting conversations and changing the stigma that surrounds type 1 diabetes. The online and offline support group allows people to share stories, mutual interests and coping strategies. She also hopes that the group can help make diabetes management technology more accessible to people remote towns and villages when possible. Lalvani also supports others as a certified diabetes educator and certified pump trainer.
Come December, Lalvani and four others with type 1 diabetes will embark on yet another first: a 100-kilometer walk through the outskirts of Mumbai. With technology and management skills on her side, she is confident — and she thinks others should be, too.
"I would like to tell people that they can do whatever they want to do," she said. "Don't be afraid and restrict yourself. Everything is possible."
And while she is unquestionably destined for more great things, Lalvani doesn't get caught up in what might lie ahead. She's already building her future every day.
At the beginning, she just wanted to be normal. With her sense of adventure and determination, and some help from life-changing technology, her feet picked up pace as did her dreams.
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