My name is Mariana. I was born and raised in Mexico City. I have been living with type 1 diabetes since 1984.

I would like my NCD Diary to serve as an awareness tool on prevention for decision-makers and the public, and to empower my diabetes peers to advocate for each and every one of us.

Written Diary

19 October 2022

Diagnosing on Time and Preventing Grief

Type 1 diabetes did not come "suddenly and without warning". I had already been feeling very tired for several days. I remember that my body ached, and my parents told me that it was probably just pain due to my bones and muscles forming as I was still a child. My head hurt so we suspected that I would surely need to wear glasses like my dad.

We visited the paediatrician not once but many times. He prescribed treatment for various infections: respiratory tract, urinary tract, but I was still feeling bad.

One day I woke up feeling very thirsty. We lived in a small apartment, and I’d sit on a small armchair near the bathroom door. I always had a large glass of water next to me. I drank and drank. Every time I went to the bathroom my thirst was so intense that I would literally stick my head under the faucet to take a sip.

My parents decided to take me to the paediatrician once again.

Now he, sure of himself, indicated that it was probably appendicitis since I was already breathing very hard and had very intense abdominal pain. My parents, distressed and realising that the paediatrician friend whom we trusted completely had no idea what was wrong with me, decided to take me to a private hospital far away from home.

They put me on an IV and although it hurt enough to cry, I didn't have the strength to even say "ouch". I remember that they took off my pijamas and put me in a white bathrobe and suddenly... I fell into a coma and was taken to Intensive Care. The news was not encouraging, but my story had a happy ending - not the common story in Mexico. Children in Mexico are not diagnosed in a timely manner so many of them die because we are not able to identify signs and symptoms to prevent their death, and because we have not been able to unite to demand that they be diagnosed in time.

If decision-makers and healthcare professionals knew the importance of timely diagnosis, this could be a different story. If there had been enough information in my paediatrician's office more than 30 years ago, we would have prevented my diabetic ketoacidosis. This same information could prevent the deaths of many others, and I would not be reading daily news of children, adolescents and adults losing their lives to diabetic ketoacidosis.

Written Diary

27 February 2023

Challenges for NCDs. We need to work together.

In Mexico, according to data from the Type 1 Diabetes Index, there are about 89, 834 people with whom I share a life condition. Type 1 diabetes cannot be prevented but the complications and co-morbidities can.

Mexico currently ranks ninth in the world in the prevalence of diabetes. Those living with type 1 diabetes, in Mexico, have had problems accessing insulin at some point. Indeed, by the time diabetes and its complications are diagnosed, productive years of life are lost, with significant repercussions in terms of indirect costs.

The treatment of secondary health complications, like diabetic retinopathy, diabetic nephropathy, represents a gigantic investment posing a huge financial burden on the healthcare system. This burden is entirely avoidable if proper access to on-time treatment and diabetes education is provided.

While this will represent a cost, it will also represent savings because it will be more expensive to pay for complications than for timely treatment. The COVID‑19 pandemic was a reminder of the importance of identifying, screening, and treating underlying conditions. In some countries, these health conditions worsened the outcomes of COVID‑19 in ways we had not seen before.

In 2009 I met Beyda, a girl in the Southeast of the Mexican Republic. She was diagnosed with type 1 diabetes and was hospitalized for over a week. Upon leaving the hospital, in the care of her grandparents, she had to learn how to measure her blood glucose and inject insulin. Soon her family discovered that the health system was not able to provide syringes, glucose meters, or test strips to manage her disease. Since her diagnosis, Beyda has been a beneficiary of support provided by civil society organization one of the only non-profit organizations and it was only in this way that she has been able to have access to the tools she needs to survive. Many, like Beyda, do not have access to the basic tools and are at greater risk of developing complications. Management of type 1 diabetes is improved through factors like adequate nutrition, physical activity, mental health screening, and timely treatment, just to name a few-but are often neglected.

In Mexico, health insurance will not cover pre-existing conditions and just a few will have the financial capabilities to acquire health insurance.

We, people living with type 1 diabetes, need to row towards the same shore with organizations, prioritizing our needs to enjoy a good quality of life. After all, advocating for NCD prevention and control will help us build a bright future.

Written Diary

27 February 2023

Our future

We've been told that "the action that we take now can shape our desired future". I cannot entirely agree. I believe that the action that we take now should shape everyone's desired future.

NCDs, such as heart disease, cancer, chronic respiratory disease, diabetes, and mental disorder, are the leading cause of death and disability. Aren't we all interested in preventing premature deaths? Every two seconds, a person dies prematurely from an NCD. Don't we all have more than two minutes to plan and advocate to prevent this? Isn't this a priority for everyone? 

Each of us decides the story we want to share and how we wish to tell our own. Even when each of us has different narratives we can all agree that those of us writing have been extremely privileged: we're still here and it is now our responsibility to help others change their own story. Participating in efforts that will benefit everyone must be our top priority.

WHO’s Global Diabetes Compact is working to have us meaningfully engaged to amplify the importance of acting on the things that matter the most for each and every one of us.

Sounds simple.

  1. Work together:
    1. If you're someone who lives with an NCD: Let's amplify voices and use them to demand change. Health is our right no matter where we live nor the language we speak. Join groups, create learning opportunities for those who do not have the resources. Translate materials into languages that have been abandoned before. Find those who need our help the most. Become an activist not a witness.
    2. If you are a healthcare provider: advocate for us, help us find the resources we need to change other people's lives, invite us whenever you talk about us.
    3. If you're one of our government leaders: let's change lives together. Work with us to modify policies, give us a seat at your table, we can provide evidence that might guarantee a people-centered lens to NCD prevention and control. 
  2. Educate your community:
    Sharing your story will help raise awareness. Spread the message in your own community: your school, your church. You might find someone that can take your message where it'll be heard.
  3. Know your representatives:
    Find those who will take decisions for yourself and your community. Share your concerns, find solutions, volunteer for your cause and your community.

NCD Diaries

We must guarantee our right to health no matter where we are, where we live and the language we speak.

Mariana Gomez, lived experience of multiple chronic conditions, Mexico


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