Danielle Pacheco was 13 years old when she found out she had type one diabetes.

The 31-year-old has now been living with the condition for more than 17 years and refuses to let it stop her from living her life to the fullest extent.

“It’s a huge adjustment but what I want people to know the most is you can live a normal life with it,” said Ms Pacheco, who spoke to The Royal Gazette along with Bermuda Diabetes Association educator Sara McKittrick in honour of Diabetes Awareness Month. “I’m not going to lie and say it’s great — no two days are ever alike but it hasn’t stopped me from doing anything.”

Ms Pacheco had type one diabetes diagnosed when a urine test on February 18, 1999, came back positive for glucose.

“I had all of the symptoms; frequent urination, loss of appetite, drinking a ton of water, really tired and severe weight loss,” she said. “I actually went down to 59lbs when I was 13.”

She spent a week in hospital learning about the condition — an autoimmune disease in which the pancreas stops producing insulin, a hormone that enables people to use the sugar from foods eaten to provide energy. It happens when the body’s immune system attacks and destroys the insulin-producing beta cells in the pancreas. The exact causes of type one are not fully understood. But unlike type two diabetes, its onset has nothing to do with diet or lifestyle. It is not preventable and there is no cure.

Ms Pacheco said: “Type one should be called ‘apples’ and type two ‘broccoli’ — it’s two completely different diseases.”

She added that there is “a lot of ignorance” and “undereducation” about the two types. “You have diabetes? You’re not fat,” is something she has heard often.

“I didn’t do anything to get it. It’s an autoimmune disease. It’s not my fault. Type one is not due to a poor lifestyle, it’s not due to drinking too much soda. If you’re not a close friend or a family member, you wouldn’t know that I have diabetes because I hide my pump underneath my clothing and I just don’t care to have conversations about it. The world and society put such a negative connotation on diabetes as a whole and it causes a lot of pain and anxiety for me because I know the difference but I feel like I’m constantly trying to be an advocate for myself.”

Ms Pacheco manages her type one diabetes with an insulin pump. This administers lifesaving insulin via a tube inserted under the skin “as opposed to taking a pen out with a needle and giving a shot”.

“Every 15 minutes it gives me a basal rate, a little zap of insulin. I don’t feel it. That just tries to keep me level.”

When she eats, she has to enter her blood sugar concentration and how many carbohydrates she has eaten.

The pump will work out how much insulin she needs. She had to have eight to ten injections daily before getting her pump, and said: “The pump allows freedom and to feel more normal. On injections I would have to wake up every day at 7am, no matter the day of the week, I or my mum would have to give me two injections and then I’d have to eat, otherwise I would go low.”

She would need more injections throughout the day but the pump has adjustable settings so she can sleep in, skip breakfast, or have dessert with dinner — before this meant another injection. She still has to prick her finger ten to 12 times throughout the day to check her glucose levels are not too high or low.

“If my blood sugars are running high, I’m tired, exhausted. If I have a low, it’s the equivalent to running a marathon, they say. It takes everything out of you.”

Estimating the amount of carbohydrates she’s had when eating out can be difficult and travelling is also “interesting”. Despite having a letter explaining her condition, she has been harassed in airports for having apple juice — her preferred method of correcting low blood sugar.

“What if I’m on an aeroplane stuck on a runway for five hours? I think of every ‘what if’ because I never want to be caught out.”

Along with her mother and the rest of her team, Ms McKittrick has been an enormous support for Ms Pacheco.

“I thank God every day for her,” she said.

“If it wasn’t for her, I don’t think I’d be here today. She’s so much more than my diabetes educator and dietitian. She’s been there for me through many different situations.”

And Ms McKittrick added: “We’ve had some scares with Danielle and things haven’t been easy. She works every day diligently to prevent complications.”

Ms McKittrick stressed that with a type one diagnosis “nothing changes and everything changes”.

“You have to know suddenly how many grams of carbohydrates are in the meal you are eating which you took for granted before because your pancreas did the maths for you. You can still play the games and do the sports but you now have to figure out what is going to happen to your blood sugar.

“So you do everything as before but you suddenly have to relate it to how it is going to affect your blood sugars. This doesn’t have a remission or a respite, it doesn’t have a Sunday off.

“It takes a lot of commitment, a lot of effort. You have to make an allowance for everything but there is no greater reward for doing all it takes to live well with diabetes.”