I REMEMBER COMING downstairs and telling my parents I didn’t feel good. Then my world went black. It was my first episode of high blood sugar from a lack of insulin.

I spent the next few days at a hospital, getting injections, watching Peter Pan, and counting ceiling tiles. Finally I went home.

My mother, who was terrified of needles, would regularly have to prick my finger and squeeze blood onto a test strip to check my blood sugar. The small machine took an agonizing minute to tell me whether I could eat pizza with my family, or a cookie, or anything a normal kid could eat. A minute is a long time for a small child.

In grade school I learned to test myself. I could often guess the number before I saw it. Thirst and nausea told me it was high. Shaking and spotty vision told me it was low. By the time I was ten, I was injecting myself with insulin.

In my early twenties I found an insulin pump that required no tubing. My life changed. I no longer needed injections. It seemed like things were looking up — until my insurance changed, which meant a three-month supply of the pump equipment would cost me more than two thousand dollars out of pocket. I tried the only pump covered by my insurance, but it was still too expensive.

With my rent and other bills, I couldn’t cover the cost of any pump and returned to self-injections. For four years I struggled to manage my blood sugar using multiple daily injections and frequent finger sticks.

Since I had poorly controlled my diabetes, I now suffer from retinopathy, which requires eye injections every eight weeks.

When my insurance changed again, I was able to afford a glucose monitor, which allows me to see my levels in real time, and I do yoga and kickboxing to help regulate my levels. This is my life with type 1 diabetes. The good times are always accompanied by the fear that tomorrow my insurance company will say, “Sorry, you don’t need these”; that I will not be able to get insulin because of the cost.