{Interview} Dawn Adams, midwife in northern ireland
T1D Inspiring Interview Series: Dawnie
Meet Dawn Adams, also known as Dawnie, a midwife living in Northern Ireland with her husband Roger. Her full time job as a midwife is dedicated to helping women bring life into the world, and her advocacy work tirelessly focuses on how little research there is to support women cope with the life-altering effects of menopause alongside type 1 diabetes. It’s my pleasure having her here!
The questions
Please tell us a bit about who you are where you live, your family, what you do.
My name is Dawn, and I’m the eldest of three siblings. I’m married to Roger, whom I started going out with a few days before we began A-level exams at school. We’ve been together almost 36 years, and we’ll be married 30 years this summer. We have four sons and a cat.
After finishing an education degree at Stranmillis, a college of Queen’s University in Belfast, I initially worked as a primary school teacher. After my youngest son was born, I returned to Queen’s and completed a degree in midwifery. I currently work as a midwife in Northern Ireland.
Tell us your type 1 journey - what age were you at diagnosis, and what was the experience like?
I was diagnosed with T1 at the age of 22, just before finals at Stranmillis. I had lost over two and a half stone in weight in 2 months; I was drinking and peeing like it was an Olympic sport; my eyesight had deteriorated, and I had repeated bouts of thrush, which were not resolved with Canestan cream and pessaries. In the few days before diagnosis, my skin was incredibly dry and splitting along the crease lines on my palms. I was so tired that I slept at every available opportunity. Despite this, I just kept blattering on.
When I returned from a weekend in Sheffield where I was part of the GirlGuiding UK delegation at a British Youth Council weekend, Roger asked me if I had been drinking whiskey – he could smell acetone on my breath because I was in a state of diabetic ketoacidosis. The next morning, I went to my GP, who didn’t think I had diabetes until I showed her my cracked and bleeding palms. That was when she tested my blood and urine. My blood reading was HI on the glucometer, and the ketone, glucose, and protein boxes on the urine test strip turned black because all those levels were so high.
I was weighed when admitted to the local hospital; my weight was just over five and a half stone. A friend from school was diagnosed the same day, and together, we spent the next 5 days learning about diabetes, how to test blood glucose, how to inject insulin, and what our new future was going to look like.
I didn’t cry until Wednesday afternoon. I had been told that morning that I would be unlikely to have children, and if I did, then 2 would be the maximum before I would have a hysterectomy. This all seemed very final and non-negotiable. I asked about menopause and was told I probably wouldn’t live that long. Aside from that one moment of incredible sadness, I was mostly accepting of the diagnosis. I had a reason why I was feeling so tired; I knew that my skin was going to heal and no food was off limits the diet sheet I was given had more food on it than I normally ate in a day because of all the snacks to avoid hypos.
One of my favourite memories is of my friend and I being allowed to walk into the town on Thursday afternoon to spend the money our family members had given us in lieu of sweets. The Ward Sister gave us a packet of McVitie’s Digestive biscuits, which we were instructed to eat if we started to become sweaty, shaky, confused, or hungry. We were out of the ward for about two hours and snacked on digestive biscuits while sitting on the wall of the hospital before wandering back in with our shopping bags from Benetton, Top Shop, Eason, and Boots. I don’t think we were actually hypo; I suspect we were just hungry as this was the longest we had been out of a hospital bed in 4 days.
In hindsight, is there anything you wish you'd known at diagnosis that you weren't aware of that would've been helpful to know?
It would have been helpful to know that this diagnosis of type 1 diabetes wasn’t an Ending. It was more of an Alternative Route, where spontaneity, while possible, would benefit from a grab-and-go bag. It would also have been good to know that my only limitation in most instances would be me and my choice to do or not do something.
You're active in the Diabetes Online Community, often speaking about menopause and diabetes. Can you tell us more about that?
I’m not actually entirely sure how my muttered rants ended up with Menopause and Diabetes being my thing. I have had a huge amount of encouragement from Heather, Elaine, and Suzi in the DiabetesUKNI office. Things snowballed after Heather co-opted me into a Menopause Facebook Live event in 2020. This resulted in me actively engaging in a menopause research project with Prof Vivien Coates and her team at Ulster University. Seeing how my ranting resonated with my peers encouraged me to agree to speak openly about the collective perimenopause and menopause experience in those with all types of diabetes.
Why was it important for you to establish a peer support group (Menopause Mithers) for anyone living with diabetes and going through the menopause?
There’s a common misconception that I am the brains behind the various Menopause Mithers accounts. Beth Baldwin and I had been chatting on Twitter and Instagram about our frustrations with the lack of information and support available during this life stage compared to pregnancy.
In May 2022, Beth set up a WhatsApp group where a few of us swapped experiences. Then, in October 2022, on World Menopause Day, she officially launched the Twitter account. I feel very fortunate to have been given Admin privileges from the early days of both accounts. We have worked to give those experiencing perimenopause/menopause from all around the world a safe space to share and learn together.
The stigma around diabetes is challenging for many of us. This is further compounded by symptoms of perimenopause/menopause, including brain fog, itchy & dry skin, disrupted sleep, anxiety, loss of confidence, and feelings of overwhelm, bringing a new level of chaos to everyday diabetes. Having a gorgeous network of people who understand the challenges and can signpost appropriately makes a huge difference.
What has been your experience of HRT?
I have found HRT very helpful. I know it isn’t the silver bullet some proponents claim it to be, but it has been the most effective tool for managing the overwhelm and the hot flushes. I have noticed improvements in terms of glucose variability, probably because hormones associated with panic and anxiety have been reined in, possibly because my sleep patterns have improved.
Some of the Mithers have encouraged me to make lifestyle changes. Since learning that herbs and spices are plants (my Home Economics teacher didn’t mention this!) I have significantly increased the number of plants I’m eating each week. I try to get out for walks or go swimming and canoeing regularly because that brings mental health benefits and sleep improvements which make both diabetes and menopause less difficult.
In your experience, what is/are the best thing(s) about T1D?
Having the chance to live well despite this diagnosis is the actual best thing. This is made possible thanks to access to free insulin, ways of administering it, and ways to check its impact. The fact that I survived to have four children and three professional careers is no small matter within a century of T1D going from being Game Over to Extended Life.
Coming in a very close second are my diabuddies. There is something incredibly special about having friends who are so chill when you have a hypo or run out of insulin or who get so excited for you when you build a DIY closed loop, or you’re given a different insulin to try.
People who wear glasses just aren’t as animated about a change of prescription lens or a new glasses box as we get about having access to something to make our lives easier if we could actually bottle the joy from diabuddy meet-ups and share that with people who feel isolated and alone with their diabetes that would be amazing.
In your experience, what are the main challenges of living with type 1?
The curveballs. Just when I think I have managed to get my ducks in a row, one of them morphs into a feral, rabid honey badger. No matter how prepared I think I am, T1D reminds me who is actually the boss – and it’s never me.
What, if anything, do you find helps in dealing with these challenges?
I think that depends on the challenge. There are some things I can accept because no actual harm was done. Other challenges have long-term consequences… those can be very painful, mentally and physically.
Where do you find support/how do you access support?
Family - > Friends < -- > Diabuddies - > online support groups - >real life meet-ups.
Can you recommend great resources (podcasts, books, accounts, or blogs)?
Podcasts: Tino and Konna’s Global Diabetes podcast is always a great listen. I really enjoy Jen Grieves’s Type 1 on 1 pods and Stacey Simm’s Diabetes Connections.
Blogs: I love Tim Street’s tech posts , Renza Scibilia’s blogs, and Kat Boreux Wells’s blogs.
Books and authors: I have enjoyed include Ginger Viera, Gary Scheiner’s ‘Think Like A Pancreas’ and Lisa Katzenburger’s ‘It Belongs to the World: Frederick Banting and the Discovery of Insulin’.
There are too many Social Media accounts to list. The ones I follow tend to be like sunshine - they make me smile while teaching me new things and encouraging me to grow.
How do you think type 1 has affected your relationship with your body?
That’s a good question… I have an awkward relationship with my body. I have massively chunky legs, which I attribute to random genes, playing netball, hockey, badminton, and mountain climbing with wee size 3 feet attached to my kankles. As the only person with diabetes, never mind T1D, in my entire extended family circle I do wonder if the legs were a forewarning…? I’m mostly grateful that this body of mine is still blattering on despite it going rogue and trying to sabotage me on so many occasions.
How do you think type 1 has changed your approach to life and living?
When I was at school, my friend’s Mum called me Pollyanna. T1D has often pushed that comparison to the limit. It has also given me a reason to do things I might otherwise have shied away from. I don’t know if that’s a good thing in itself, but it has resulted in having “What’s the worst thing that could happen?” as my benchmark. As I get older I am trying to make the most of every opportunity because I don’t know how much sand is left in my hourglass.
Type 1 is classified as a physical condition, but we all know there is an emotional burden, too. Could you describe your experiences?
Here, where I live, we talk about emotions being on us rather than in us. There are times when diabetes weighs heavily, and I ultimately have the choice to decide if I want to be crushed by a blanket of despair or not. Sometimes, I do spend more time under the blanket than is good for me, but when I take stock, I know how lucky I am compared to many of my peers. I realise that sounds very privileged, but I know things could be worse, and I’m glad they're not. I have cried about having diabetes, but as I said earlier, I'm so thankful to still be alive. That’s significantly better than many of the people I went to school with who didn’t have diabetes and who haven’t seen their babies become adults.
Where will we be seeing you next? Are there any events or conferences people can connect with you at?
I will be at HIMSS Conference in Paris in June, possibly TAD2025 in Liverpool, and the Australasian Diabetes Conference in Gold Coast in August. Aside from that, I’ll be hanging out with the #NIdoc crew at various times in various places. I’m also hopeful the Menopause Mithers will manage a wee catch-up somewhere this year.
I can be found on Instagram @t1dawnie, BlueSky @moodwife.bsky.social, Twitter @Moodwife.