The Women Who Refuse to Be Outdone by Diabetes

The quiet math of a long T1D life

There’s a piece of math that sits at the back of every long-duration T1D patient’s mind. You do it without meaning to, usually in the middle of the night when the CGM alarms again.

You subtract your diagnosis year from the current year. You compare it to your age. And you realize, quietly, that this disease has been with you longer than most of your friendships, most of your jobs, and — for some of us — longer than the doctors now treating us have been alive.

I was diagnosed with Type 1 Diabetes in 1983, at ten years old. Forty-three years later, I’m 53, and I know the shape of that math intimately. I also know that it’s nothing next to the women who’ve been doing this for five, six, seven decades.

A piece published by the diaTribe Foundation — the nonprofit advocacy and education organization founded by Kelly Close — celebrates a handful of those women. I want to talk about what their stories look like from inside the disease, from someone who has watched the same arc from the men’s side of the ward.

Fifty-five years. One sentence.

One of the women profiled in the diaTribe piece is Evelyn Oberdorfer. She’s 66. She was diagnosed with Type 1 Diabetes in 1968.

Let that settle for a second.

1968. Richard Nixon had not yet been elected. The A1C test did not exist. Home blood glucose meters did not exist. The idea that a person with T1D could safely run a marathon — let alone fifteen half marathons — would have been laughable to the average physician of the day. The standard of care was a single daily injection of long-acting insulin and a urine test that told you what your blood sugar had been hours ago.

Evelyn is still here. Fifteen half marathons later. Three bodybuilding awards later. A former paralegal. A former national fitness educator. A grandmother. She told diaTribe, in what I think may be the single most important sentence I’ve read in a diabetes publication this year, that she “never wants to be outdone by diabetes.”

Fifty-five years into this disease. Still refusing to be outdone.

I read that and I put my laptop down.

What fifty-five years of T1D actually costs

I’ve written before that the unglamorous 95% of Type 1 Diabetes is the decisions you make every hour of every day, forever. Let me do that math for Evelyn.

Assume, generously, that she’s making roughly eight conscious T1D decisions per day — food, dose, correction, activity, sleep, sick-day adjustment, device maintenance, mental triage. Over 55 years, that’s more than 160,000 decisions. Not choices. Medical decisions, most of which a non-diabetic nervous system handles automatically.

That is the cost of a long T1D life that the pamphlets and the fundraising galas never price correctly. It is not the syringes. It is not the insulin. It is the relentless, invisible executive function.

What Evelyn’s sentence says — “I never want to be outdone by diabetes” — is not a motivational slogan. It’s the posture you have to take every single day for 55 years or you lose. It is the same posture I’ve seen in my own life for four decades, but she has been holding it for twelve years longer than I have.

The women-shaped gap in T1D care

The diaTribe piece lands in a landscape that still, in 2026, has a women-shaped gap in it.

Women with Type 1 Diabetes navigate things the typical clinical trial cohort doesn’t. The hormonal pattern of a menstrual cycle can produce insulin resistance swings of 30% or more in the luteal phase, and the textbooks are still catching up to it. Pregnancy with T1D is a clinical tightrope that requires women to essentially run a parallel endocrine system for nine months. Perimenopause and menopause produce a second hormonal rewrite, and clinicians are often unprepared for how it affects glycemic variability.

Communities have filled some of the gap where the research has been slow. DiabetesSisters has spent the better part of two decades building peer support specifically for women across every type of diabetes. Touched by Type 1 runs programs that lift young women and girls with T1D into leadership roles. Beyond Type 1 has written extensively on pregnancy, mental health, and the particular weight of a T1D diagnosis during reproductive years.

The American Diabetes Association’s Standards of Care in Diabetes — 2025 now includes more explicit pregnancy-and-T1D guidance than it did even five years ago. That is progress. But progress is not the same as arrival.

What a lifetime of watching teaches you

Here is what I want to say carefully.

I am a man. I have lived with Type 1 Diabetes since 1983. I have never been pregnant while dosing insulin. I have never had a menstrual cycle rewrite my basal rate four days a month. I have never been told my symptoms were anxiety by a rushed ER doctor. I am not the right person to tell women with T1D what their experience is.

What I am the right person to do is this:

I can tell you, from four decades inside this disease, that the women I’ve met with the longest T1D durations — the 40-year, 50-year, 60-year patients — are disproportionately the best-informed, most resilient, most relentlessly self-advocating patients in any endocrinology waiting room I’ve ever sat in. They had to be. The medical system they came of age in did not come to them. They went to it, and they pushed, and they learned the science themselves, and they built communities when the system didn’t have one for them.

Evelyn Oberdorfer did not do fifteen half marathons because she had a great care team. She did fifteen half marathons because she decided, fifty-five years ago, that diabetes was not going to file her life down to a smaller shape.

Three things worth borrowing from women like Evelyn

If you are newly diagnosed, or supporting someone who is, or 20 years in and starting to feel the weight — here are three postures I’ve watched these long-duration women hold. They are not medical advice. They are a way of standing up.

1. Refuse the small life

The most dangerous thing a T1D diagnosis tries to sell you is a smaller version of your life. It whispers that you should not run that race, take that job, have that baby, climb that mountain, lift that barbell. The women in the diaTribe piece — and the women I’ve known in four decades of T1D community — have said no to that whisper again and again, in a hundred different ways. The refusal is the intervention.

2. Build your own research team

I do not mean an actual team. I mean: you become the person in the room who has read the primary source. The long-duration women I know do not take their endocrinologist’s word as the end of a conversation. They bring the paper. They ask about the footnote. They compare their CGM data to the standard of care document. They teach their clinicians. It is exhausting and it is also, in a medical system that still undercounts women, protective.

3. Find the other women

This one I cannot speak to from the inside, but I have watched it work from the sidelines for decades. Women with T1D who find other women with T1D — through DiabetesSisters, through Touched by Type 1, through local peer groups, through Instagram communities, through the quieter Facebook groups that moderators have been running since 2007 — get through this disease differently than women who try to do it alone. The community is not optional infrastructure. It is primary care.

A quiet thank-you

I started this site to publish what four decades of T1D have taught me. I started it for the millions of patients and families walking this road. But there is a group of people I specifically want to write for, and the diaTribe piece reminded me of them.

To the women who were diagnosed in 1968, and 1972, and 1979, and every year since. To the ones who learned to run insulin without meters, and to dose without pumps, and to parent without CGMs, and to advocate without community. To the ones who told a sixties-era doctor, “I am going to have a normal life,” and then spent the next five decades making it true.

You have been refusing to be outdone by diabetes for longer than some of the engineers who built my current insulin pump have been alive. The rest of us are walking in the path you cut.

Thank you.

— John Chitta

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This article draws on the diaTribe Foundation’s piece Celebrating Strong Women Living With Diabetes. All factual claims about Evelyn Oberdorfer, including her diagnosis year, race history, and bodybuilding awards, come from that source. The interpretation, framing, and opinions are my own, written from a lifetime with Type 1 Diabetes since 1983.

References

1. Celebrating Strong Women Living With Diabetes · diaTribe Foundation
2. DiabetesSisters — Peer support for women with all types of diabetes · DiabetesSisters
3. Touched by Type 1 — Programs and community · Touched by Type 1
4. Standards of Care in Diabetes — 2025 · American Diabetes Association
5. Beyond Type 1 — Women and T1D resources · Beyond Type 1