Nick Jonas has revealed that, 21 years after being diagnosed with type 1 diabetes, he sometimes wonders what life would be like without the condition. The singer, 34, was diagnosed in November 2005, aged 13.

Jonas made the admission in an open letter to the condition for Dexcom's A Letter to Diabetes initiative. He wrote that the disease has not changed 'a bit' even after 21 years and still demands hundreds of decisions each week.

Jonas now manages the condition with an insulin pump, frequent glucose checks and advice from his doctor. He has also found support by talking openly about life with type 1.

Daily Decisions, Constant Monitoring

Jonas checks his phone every few minutes to see where his glucose is. He also reaches for his insulin pump to give a bolus, or a dose of insulin, before eating something with 17 carbs.

Most people never notice those decisions, but diabetes is an ongoing conversation between the body, the mind and the devices. It is, in essence, a real relationship.

Type 1 diabetes is a chronic condition in which the pancreas makes little or no insulin, according to Mayo Clinic. Insulin is a hormone that lets sugar, or glucose, enter cells to produce energy.

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When Control Gives Way

Some days, he and diabetes seem to be on the same team. On other days, the condition goes on a solo mission, and it does not matter how careful he is.

Even with a solid grip on management, there are times when his body just does what it wants. The disease is unpredictable from day to day.

The unpredictability threw him at first. He had built his life around an unrealistic belief that he was in control, and the disease took that apart bit by bit. Part of him is grateful for the lesson, while part of him resents the condition for it, 'full stop'.

Symptoms, Risks and Complications

The exact cause of type 1 diabetes is unknown. The immune system destroys the insulin-producing islet cells in the pancreas, and genetics and exposure to viruses may also play a role.

Symptoms can appear suddenly and include increased thirst, frequent urination, hunger, unintended weight loss, fatigue and blurry vision. A person who notices these signs in themselves or their child should talk to a doctor.

Without insulin, sugar builds up in the bloodstream, and that can cause life-threatening complications. Over time, these can affect the heart, blood vessels, nerves, eyes and kidneys.

Keeping blood sugar at a normal level can lower the risk of many of those complications. Diabetes complications can lead to disabilities or even threaten a person's life.

Managing Type 1 Every Day

Jonas uses an insulin pump, checks his blood sugar often and works to get to know his body so he can tell when he is high or low. He also credits trusting his doctor and following her advice.

Staying honest with trainers and friends about the disease helps when problems arise. In 2023, he said his brothers, Kevin and Joe, help normalise his care and make sure he has juice if his glucose starts going low.

Finding Community and Support

Jonas long struggled to feel that he belonged and felt misunderstood at school and in most circles. That changed once he began talking openly about life with type 1 and meeting others who were living it too.

Jonas co-founded the nonprofit Beyond Type 1, which aims to change what it means to live with chronic illness. He shares his story for the 13-year-old who has just been diagnosed and is lying in a hospital bed, 'scared to death'.

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