Sarah from Cork City recently completed the Schull Triathlon in two hours and four minutes. Covering a 750-metre open-water swim, a 20-kilometre cycle and a 5-kilometre run, Sarah managed every stage with the help of her family and diabetes technology.
It is a feat she would never have imagined eight years ago, when she was first diagnosed with gestational diabetes during her first pregnancy.
At 20 weeks pregnant, Sarah showed no symptoms, but routine urine tests revealed high blood glucose levels.
“They asked me to do a glucose tolerance test and that came back positive,” she recalls. “I could not understand it. I was following all the advice of my maternity team and living a healthy lifestyle. I felt devastated and worried I had somehow harmed my baby.”
A second opinion from her GP confirmed the diagnosis, yet the only advice she received at the time was to avoid fizzy drinks, something she rarely consumed anyway.
Sarah, now 40, has two children aged five and eight. She was informed during both pregnancies that she had gestational diabetes, which can increase the risk of developing Type 2 diabetes later in life. Routine workplace health screening suggested she was pre-diabetic and she was prescribed metformin.
“I was not overweight and I had a healthy diet,” Sarah says. “My GP recognised that I did not meet the criteria for developing Type 2 diabetes and questioned the medication.”
Diagnosis with Type 1 Diabetes
In December 2023, at the age of 38, Sarah began insulin therapy following a diagnosis of Type 1 diabetes. She had previously been told in 2021 that she likely had Type 1, but her condition progressed slowly, which is characteristic of latent autoimmune diabetes in adults.
“While I felt a sense of relief at finally receiving the correct diagnosis, it was hard to accept this was something I would live with for life. I felt validated that this was not something I had caused myself,” she says.
Managing Mental Health and Embracing Technology
Balancing work, family and diabetes management can be overwhelming. Six months into taking multiple daily insulin injections, Sarah experienced diabetes burnout, feeling mentally and emotionally exhausted by calculating carbohydrates and insulin doses. Her GP prescribed antidepressants, which helped her manage the stress and be more present with her family.
“When I am out with my children now, I do not constantly worry about feeling low or queasy. My phone alerts me if action is needed and I have confidence,” she explains.
Technology has been a game changer for Sarah, especially in sport. She took up running and sea swimming in 2021, and when she began insulin therapy, she was initially anxious about the risk of hypoglycaemia while swimming. She started training in shallower waters and relied on continuous glucose monitoring (CGM) to stay safe.
Access Challenges and Advocacy
Sarah’s diagnosis coincided with new government CGM reimbursement policy for Type 1 diabetes, yet she was initially denied coverage due to her atypical presentation. After nine months of emails, Freedom of Information requests and appeals, she finally received CGM reimbursement in late 2024.
“CGM technology should be available to all people with Type 1 diabetes, including those with delayed or atypical diagnoses like mine,” she says.
A Positive Outlook
Sarah encourages anyone with diabetes to find local support groups and attend events such as Diabetes Ireland’s Health Awareness Exhibition. Receiving her diagnosis as an adult has allowed her to continue her sporting activities without restriction.
“I never thought I could not do something because I have diabetes. Growing older is a privilege, and I am enjoying every moment of it,” she reflects.
