Sex, technology, and diabetes

"A $6,000 insulin pump with an on-board computer chip is not alluring. Neither is the white mesh adhesive patch on my naked abdomen or the length of nylon tubing that connects the patch to the pump. There is only illness, and there is no way to make that sexy. After several years as a medical device wearer, I know."
Those are the opening sentences of "Tethered to the Body," an essay the writer and teacher Jane Kokernak wrote about her adjustment to wearing an insulin pump and its affect on her sense of sexual self. It connects disability and sexuality in novel and moving ways (it also introduced me to the term "disability erotica"). The essay, which originally appeared in Bellevue Literary Review, has been reprinted in A Sweet Life, a site for the "healthy diabetic." The story is close to me for many reasons. I'm diabetic, too, although I am not insulin-dependent, and, more important, Jane is my wife, so the sex she's talking about in the essay is with, well, me. You may wish to consider my recommendation with that in mind, but I guarantee you that this will be the only piece you ever read in which the two tags are "Insulin Pump" and "Sex."


  1. I thought this essay was really interesting, until I realized that the name of the author sounded a bit too familiar.

    Then I realized that she was one of my writing advisers in a project class last year. Suddenly it went from interesting to “TMI man, TMI.”

  2. “A $6,000 insulin pump with an on-board computer chip is not alluring.”

    Yeah, right. This is BoingBoing, after all.

  3. Hi. My wife is a Type I diabetic, she’s had a pump for about 12 years (longer than we’ve been dating). Our experience has been completely unlike this essay. Diabetes isn’t always easy to deal with, but I have not encountered problems related to her pump.

    Thgh th thr s clrly wrtng frm hr wn xprnc, rd t s whny slf-pty, nd mstly jst wnt t cll bllsht n t. “Whn Whn. ‘ll nvr b th whlly nkd slf mgnd s 12 yr ld”. ‘m nhppy t s bngbng pshng t.

    Speaking pragmatically, my wife’s pump (which I believe is the same model as the author’s) will clip to a garter belt, or a leg band. Which makes negligees and nudity entirely reasonable. We sleep nude, and her pump floats on it’s tether. When spooning it’s usually down around our legs somewhere. Sometimes I notice it and shift it, but calling it an imposition is vastly over stating it. It gets in the way less than the blankets.

    Our science fiction friends find it closest to a cyborg. Something that should be attractive to the general boinboing reader.

    For support groups, and general like minded people. is a pretty good resource.

    1. Please, this is a post about a woman made by the husband of that woman. How would you like it if someone called you or your spouse a whiny self-pitying bullshitter? Instead, I’ll call you rude. It’s one thing to critique, it’s another to be purposefully mean about it.

      I thought the post and accompanying article were important and the article was very intelligent and well thought out. Perhaps it’s not your experience, but it is her experience. Sexuality is very individual, and different people experience it in radically different ways.

  4. “When I catch a glimpse of my nakedness in the bedroom mirror, I see an imperfect woman and the signs of her vulnerability.”

    That is about the sexiest thing I’ve ever read.

    I’ve been on the pump for a while, too. There’s tons of annoyances, but honestly, just unhook the thing while you are having sex. Suspend the pump and tuck it on the night stand or under the pillow. Surely the exercise you are getting from having sex takes up some of the slack from the lack of basal insulin you aren’t getting for that time.

    I was most worried about sleeping with the pump when I was considering getting one. I don’t like sleeping with clothes on, so how would that work? Turns out it just sort of “floats around” like anon’s wife’s pump. Sure, sometimes it gets in the way, or I lay on it the wrong way, or the tether gets wrapped around my torso in a bothersome way, but mostly it’s just fine.

    While it may not be the sexiest thing in the world, I found that feeling so much healthier and having stable blood sugar made sex better with the pump than when I was on the shots and I sometimes felt too sick to perform. That, and the cyborg things is kind of cool, too.

  5. I have to wonder whether the economic and social advantages that allow for access to these devices also allow for the luxury of treating one’s insulin pump or one’s sex life as an intellectual exercise. Type I Diabetes (note: if you are not insulin dependent, you have a radically different disease) was until relatively recently fatal. Before insulin pumps, it was much more difficult to live with. Improvements such as closed systems including continuous glucose monitoring allow for a life with more spontaneity (sexual and otherwise), not less. I’m all for valuing that rather than fostering more misconceptions about the kind of life you can live with this disease.

  6. I was diagnosed with Type 1 over 20 years ago and have lived my entire sexually-active life as a diabetic–with both the syringe regime and the pump.

    I tend to think taking off the pump and forgetting about it is the easiest way to deal with the situation. It will not do appreciable damage to the body to have it off for even an hour. Be in the moment and when you are done put it back on and go to sleep. Obsessing over fantasies and images of what your body and sex should be like will only remind you of some mythical standard of sexiness or even ablebodiness that does nothing to enhance your life. Your pump will be there when you get done having fun with your partner who wants to have sex with you just as you are.

    1. “It will not do appreciable damage to the body to have it off for even an hour.”

      Wish I got chance to just have it off ;)

  7. I dated a girl in HS that wore an insulin pump, never once thought it made her any less attractive and it never really caused any complications during sex. Hillx075 is right too, just suspend and unhook the pump for sexual activity (it’s really a no brainer). Hell, half the time I was the one measuring insulin, changing cartridges in the pump, and priming the pump anyway.

  8. I think this post was great. The topic and how your wife feels about it could only have be difficult to write. Well put together essay, with way more heart than most.

    Somewhat off topic though, has anyone on this forum taken a look at the idea of research for treatment of disease vs. research for a cure. I understand treatment saves lives. At what point though am I morally 100% correct to be angry about money being spent on a 5 second blood test machine(instead of the old 10 second model) vs. spending that money on research for a cure?

    And please no rants on the power of the free markets. Treating diabetes will always make people more money than curing it, but having said that where do cures come from? So if Glaxo-Smith-Kline makes x per year, should they not be required to spend a percentage on Cures and not more profitable treatment methods?

  9. My partner had pancreatitis 2 years ago. He was in the hospital for over 2 months and left almost 80 pounds lighter with 4 abdominal drains collecting necrotic bits of his pancreas and assorted fluids of all types. We joked that he was like Dr. Octopus with his 4 extra protrusions. He was previously, remained, and still is the sexiest person I’ve ever met.

    I hate to say it, but if you don’t feel sexy you need to look beyond the insulin pump. It’s not the problem.

  10. I love watching my girlfriend do science with her blood sugar. It’s awesome. :) She has programmed her insulin, her food, her blood consciously for most of her life. She can sum a meal’s nutritional facts at a glance. These are signs of uncommon strength. They are part of her. Is she less sexy for it? Not at all.

    This article implies that sexiness is objective. It isn’t. :) Sometimes hair and elbows and breasts get in the way during sex. Whatever will we do about that?

  11. I’m speaking as a Type 1 diabetic for 37 of my 40 years, and an insulin pump user for 15 of those years, married to a woman who isn’t a diabetic but IS in a wheelchair.

    I feel for the author, but the pump itself is NOT the problem. At all. Negative self-image, on the other hand, can be devastating. I don’t want to sound callous, but get over it — if my partner can deal with being in a wheelchair and still feel sexy, I don’t see how a tiny tethered-but-detachable pager-sized lifesafer should make any difference.

  12. The alarm, it says (to us at least), “shame on you.” And I cut myself on my wife’s port while, ahem, “conserving water” in the shower. Who knew? Seriously though, that pump has made my wife more independent, healthy and has enabled us to have two children. Now that is something that was not possible a few short years ago. Yeah technology!

  13. Hey! Check out Irely (pronounced eye-r-ly) at They make fabulously sexy – and extremely comfortable! – intimates for women. Their underwear have what they call a “secret side”, which is a hidden pocket in the waistband that sits in the small of your back. It’s perfect for an insulin pump! So it can stay out of the way, concealed, and women feel beautiful, confident and confident!

  14. I have a friend who wears an insulin pump, and she is one of the sexiest women I know. I’ve seen her wearing it with lingerie, clipped to a garter, and it does nothing to distract from her beauty or sensuality. (If anything, the fact that she ends up wearing gartered stockings so often just makes her hotter.) It’s all in how you see yourself… and your pump. If you don’t let it take away from your sexiness, it won’t.

  15. Can anyone propose a solution to the problem of remembering to re-attach. I am thinking a timer tray that beeps a certain time (45 min?) after something is placed in it!

    1. Mine beeps and vibrates every 10 minutes or so when it is suspended / off my body. If I’m lazy, it’s sort of hilarious when ‘in the throes’ because it plays a sort of stilted version of some Beethoven tune.
      If I’m subtle, I’ll put it under the pillow so it’s not so loud, but I can still hear it when I slip into a (n inevitable) post-coital nap.

  16. I am sorry to hear that Ms Kokernak feels her insulin pump interferes with her sexuality. However, in reading her article, I don’t actually see that this is much about the technology at all.

    Perhaps changing her diabetes management has in some way highlighted for her her own ideas about sex, mortality and chronic illness.

    As a woman with type 1 diabetes who has used an insulin pump for more than a decade I’m sad that somehow these emotional issues have been tangled up with questions of using a pump.

    Diabetes is a difficult challenging disease that is fraught with frustration. I find that it often highlights my mortality and the fact that I can not control and account for all of the details in my life. But everyone is mortal, and no one truly has full control.

    My pump is like my glasses. It is an assistive device that allows me to function with my body’s short-comings. Its affect on my sexiness is in the eye of the beholder, remember some people think a girl in glasses is HOT!

    Ms. Kokernak’s statement, “I cannot be completely caught up in the moment, because I’m calculating what to do with the pump and when,” makes me worry that a partner of mine might think that I’m not capable of being “completely caught up in the moment” just because of my pump. Sex with me is in many ways like sex with any other woman. Sometimes you have to deal with an annoying interruption (your mom calls at the wrong moment, you trip on an extension cord, you can’t find the condoms, the kid has a nightmare, or my pump beeps to let me know that I’ll need to change my cartridge sometime in the next 24 hours). But the possibility of these interruptions in NO WAY impedes my ability to get caught up in the moment.

    If the simple practicalities of integrating an insulin pump with some sexy lingerie is a problem, use your imagination. Some of the sexiest femmes fatales to ever grace the silver screen had something (a flask, a handgun, a pack of cigarettes) tucked into their garter topped stockings. (If you really want a belt and suspenders, use the “stay up stockings” AND a garter belt, that pump isn’t going ANYwhere.)

    I second the recommendation for they are an excellent resource for finding people of all ages and persuasions using insulin pumps, and discussing the attendant realities.

    I sincerely hope that future technical discussions of insulin pumps do not imply that they are in any way likely to impede their wearers sex lives.

  17. First of all, no one, and I mean no one, is going to suffer any consequences from disconnecting the pump from the skin port for an hour or so. That’s why they are made in a manner allowing disconnection. Your pump tech should have informed you of that.

    Seconf of all, what’s sex? I guess it’s been so long since I’ve any any that I’ve forgotten. Yeah, I know: boo hoo, to bad for me.

  18. “Somewhat off topic though, has anyone on this forum taken a look at the idea of research for treatment of disease vs. research for a cure.”

    Yes, there is a lot of money going into cure or long term solutions type I diabetes. Please check out the Juvenile Diabetes Research Foundation ( to see what kind of research is working towards a cure and maybe even take time to donate. They are a great group and over 80% of their money goes to research and education.

    My son has type I diabetes and I have to say that the pump has been marvelous and we are looking at a continuous glucose monitoring system. Hooray technology!

  19. I appreciate author Jane’s viewpoint, and thank her (and Boing) for sharing it. My daughter, age 8, has been pumping for 5 years. She knows no other life, but someday, she’ll want to be Like Everyone Else…and I want to know how to prepare her for the fact that that isn’t fully going to happen. Not until there’s a cure, at least.

    I am considering taking the following tack with her when the Time Comes for her to be sexual with another person:

    1. Time for some Mental Floss. OK, having a chronic condition is very wearing (no pun intended) for lots of us…even just us helpers, nevermind the people with the actual condition. But…we are fortunate that treatment of what used to be a flat-out fatal condition has progressed to the point where we can complain vociferously about the myriad things that now make diabetes fully Liveable. Not desirable–no. But liveable. Thriveable, even (okay, not a word, but you get my point).

    2. And with these treatment options comes flexibility. Pumps ain’t sexxxy–but they are removable. Take it off for sex play with your honey-pie, and bolus ahead for whatever insulin you’d miss for the next two hours (or so) while frisking about :).

    That’s what I’ll tell my sweet daughter, anyway. But I’m open to suggestions.

    Best to Jane and all t1’s here–


  20. To ANON, and others who have written that “There is NO problem disconnecting your insulin pump for an hour or so.” You might want to remember that not every Diabetic is the same.

    I am a “Brittle” – Type 1 Diabetic, who has pancreatic insufficiency. When my blood sugar is at a normal range (105), and I disconnect my pump, within 60-90 minutes without having consumed ANY food or drink before or during the disconnect period), my blood glucous climbs to 400 and over!

    Once, when my blood glucous was 110, I disconnected the pump before rigorous sex with my wife and afterwards my blood glucous meter read “HI” – and my meter goes to 600! We thought the exercise would have lowered it! I nearly had to be hospitalized.

    I’d be very careful making blanket statements that could be read (especially by new pumpers who may have a similar problem and not know it!


    my 2 cents

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