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My name is Rui Zheng. I am a fourth-year university student and an intern at the Sinocare Diabetes Foundation. On 24 January 2024, I was “born again”. Not in a poetic sense. Not spiritually. I mean that quite literally.
One moment I was a healthy 21-year-old, worrying about exams, work deadlines and what to eat for dinner. The next, I was lying in a hospital bed with diabetic ketoacidosis, being told that I would be living with type 1 diabetes for the rest of my life.
If life were a video game, this would have been the moment when the screen flashed: System notification: Host has entered emergency mode. Diagnosis confirmed. It was not exactly the dramatic plot twist I had been hoping for.
“How can someone so young get diabetes?” That was the question everyone asked. It was also the question I asked myself, repeatedly.
I was young. I was not overweight. I exercised. I did not even like sweet food that much. I had never imagined that diabetes had anything to do with me. For a short and dangerous moment, I tried to blame myself. If only I had slept more. If only I had eaten better. If only… But there is no useful ending to that sentence.
For a short and dangerous moment, I tried to blame myself
I was just as unaware as the people asking me these questions. I did not know the difference between type 1 and type 2 diabetes. Although I was diagnosed with type 1 diabetes, I thought the causes of type 2 diabetes were responsible for my diagnosis.
Now, I know better. Type 1 diabetes happens when the immune system basically destroys the cells that make insulin. Type 2 diabetes is more like the body slowly stops responding to insulin the right way and can’t keep up anymore. It’s often tied to genetics and lifestyle.
The doctors explained that the probability of developing type 1 diabetes is extremely low. One in tens of thousands. In China, approximately 600,000 people across live with type 1 diabetes, and around 117,000 are aged under 19. Most are diagnosed in childhood. I remembered my biology teacher once describing diabetes as a “disease of affluence”. At the time, I did not question it. Later, lying in a hospital bed, I decided to reinterpret it.
Becoming rich overnight is also rare. Maybe I had simply become “rich” in the wrong way. Of course, this theory collapsed as soon as the bills arrived. I had the condition, but none of the luxury.
I remembered my biology teacher once describing diabetes as a “disease of affluence”
At first, I used humour to survive. Jokes were easier than fear. Easier than grief. But diabetes is very good at outlasting jokes. Finger-prick blood glucose tests every two hours. Four insulin injections a day, straight into the abdomen. A strict meal plan handed to me with good intentions and impossible expectations.
No milk tea. No barbecue. No fried chicken. Definitely no hot pot. The solution offered was simple: “Eat at home.” And insulin? For life.
That was when I cried properly. Not quietly. Not politely. I cried until my chest hurt and my thoughts went to places I had never visited before. I wondered whether I could live like this. I wondered whether I wanted to.
Someone told me, “You are a man. You should not be sad.” So, I decided not to be sad. I decided to disappear instead.
One night, in a dark hospital room, I pushed my IV stand towards the window and calculated how simple it would be. How fast. How final. Then I heard my mother’s voice. “What are you doing?” I stopped.
The plan collapsed instantly. All that was left was exhaustion, tears and shame. I realised something important that night: when pain becomes unbearable, logic disappears first. Compassion must arrive before explanations.
When pain becomes unbearable, logic disappears first. Compassion must arrive before explanations
After that, I started to learn. Not just about insulin and carbohydrates, but about survival.
I read books. I watched videos. I scrolled endlessly through social media platforms where people living with type 1 diabetes shared their lives, their fears and their victories. I began posting too. I answered questions with confidence that exceeded my actual experience, but sincerity counts for something.
I started calling my life “manual transmission”. With an automatic car transmission, you press the pedal and go. With a manual, you must shift gears yourself. You stall. You panic. You learn the sound of the engine. Eventually, you move forward again.
I do not know whether my words helped others. I do know they helped me.
I do not know whether my words helped others. I do know they helped me
When I returned to university, people asked where I had been. I decided to be dramatic. “I got a rare condition,” I said. “You have definitely never heard of it.”
They leaned in. “Diabetes.” Silence. Then laughter. “Diabetes? That’s it?”
I felt foolish for a moment. Then relieved. If this did not make me special, then maybe it did not have to define me either. That realisation mattered more than I expected.
In China, the term “sugar baby” is often used for people with diabetes, especially children. It isn’t meant as an insult at all. It’s actually a warm, affectionate expression. More like a nickname that reflects care, protection and community support rather than anything pejorative or dismissive.
In May 2024, I visited a children’s hospital in Henan with colleagues from the Sinocare Diabetes Foundation – the first nonprofit in mainland China dedicated solely to diabetes care and education. We met an eight-year-old girl living with type 1 diabetes. The moment her mother saw us, she cried. Not quietly. Not politely. I saw my own mother in her.
We talked for a long time. Slowly, the child smiled. Later that night, she called me because she was hungry. Her dinner had been cucumbers. She had eaten two. She was still hungry.
I went outside and spoke with her mother for hours. She was the first person with type 1 diabetes I had met since my diagnosis. I felt absurdly happy, as if I had won something. I was not alone.
That night taught me something no textbook could: sometimes a few honest words are enough to help someone survive another day.
Sometimes a few honest words are enough to help someone survive another day
This may sound strange, but diabetes has improved me in small ways. I read food labels obsessively now. I have become that person. I explain the glycaemic impact to friends who did not ask. I say things like, “That is basically a carbohydrate bomb,” with authority I did not earn.
My girlfriend listens. My status at home has improved. I also have a friend who monitors my blood glucose with the seriousness of a medical professional. When my levels are high or low, he asks in the same tone my girlfriend uses: “So… what did you do wrong?”
Sometimes I know. Sometimes I truly do not.
At first, I was annoyed. Then I explained. Type 1 diabetes is not about moral failure. It is about insulin, timing, stress, hormones and chance. He apologised. I gained a real friend.
While I was hospitalised later that year, a stranger asked whether I had a girlfriend. When he learned I lived with diabetes, he said, “You will not live long. You should marry early.” I was furious.
Ignorance does not just misinform. It wounds. This is why education about type 1 diabetes matters. This is why stories matter. Thankfully, many of my experiences have been positive. Through my work and volunteering, I have met parents, children, students and advocates who understand. I am surrounded by people who care. That support saves lives, quietly.
Now, every day is a negotiation. I feel hungry. I check my blood glucose. If it is normal, I ask myself: Do I eat because I need to, or because I want to? Eating means another injection. Not eating means waiting. Once I frame it like that, my brain usually sighs and chooses patience.
I am surrounded by people who care. That support saves lives, quietly
I have lived with diabetes for less than a year. In that time, I have learned about insulin dosing, hypoglycaemia, hyperglycaemia, injections, diet, relationships and fear. Most people see an ordinary young man. Sometimes, when I look back, I feel like a hero.
Not in a dramatic way. More like the veterans in documentaries who look unremarkable until they tell you what they survived. When I meet others living with type 1 diabetes, I feel deep respect. I know what they carry. Every injection. Every calculation. Every silent decision.
And when I see them, I wish them only three things:
Health.
Long life.
And a life that is truly their own.
Thank you.
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