Betty Howard. (Fit People).

Every year plenty of people get the same Type II diabetes test results that came back to Betty Howard in 1986. But few of them live and work on a 35,000-acre ranch in southeastern New Mexico with 500-plus head of cattle and 20 horses.

Howard said the lifestyle she and her husband, Dan, share there in the high desert around Portales made following the old-school, highly structured diabetic management plan tough. For instance, to keep her blood sugar as level as possible, her treatment involved detailed computations of daily diet and exercise, along with numerous insulin shots.

But unlike 9:00-to-5:00 workers surrounded with structure--from scheduled lunch hours and a refrigerator-equipped break room down the hall--she said she always struggled to comply with the rigid prescription.

"Out working cattle, I had to pack a glucose monitor and insulin that couldn't get too hot or too cold," she recalled. And while millions of other diabetic workers can click their mouse, save a file, and step away from a computer terminal, she said taking regular breaks in the midst of weaning calves or branding is often highly impractical. Under these circumstances, she said coping with the disease became problematic in more ways than one.

It's not that she couldn't navigate life with diabetes. She originally contracted it as a complication five months into her first pregnancy. But the day she delivered Kristin in 1983, she said it disappeared and she was riding her horse again in three months.

She contracted gestational diabetes again in 1984 while carrying her second and last child, Kimberly. However, the condition also vanished within 24 hours of labor.

The disease was a memory for the next 18 months until telltale excessive thirst and urination should have driven her to the hospital. But Howard said denial caused her to put off getting a checkup until the symptoms became undeniable.

Left untreated, her diabetes eventually caused respiratory problems that could have become life-threatening. So she got tested, and the diagnosis confirmed her suspicions and, she said, changed her life in more ways than one.

"I had to be so strict when I was pregnant," said Howard, now 50. "But that was easy, because I could see the end, and there were other people to consider."

She said the new permanent diagnosis stirred a very different reaction--one of rebellion against the rigid treatment plan and a big "Why me?" question for God.

After all, Howard had competed in rodeo events such as barrel racing, breakaway roping, and goat tying well into adulthood. And the strength and dexterity used in those sports readily transferred to her work on the ranch.

Diabetes, she realized, could compromise her participation in both work and recreational pursuits. And the strict diet fed the classic American woman's preoccupation with eating.

She said ongoing low-fat, no-sugar meals created strong cravings that set her up for bingeing. Worse, she said that managing the disease to the letter meant eating even when she wasn't hungry--a "no-no" in traditional weight management plans.

"It's just been a moment-to-moment kind of thing, not any different from what anybody else's life is," she explained. "There are times when God is right there and you feel good, and other times when you're in the desert and can't find Him anywhere."

However, she said she turned a corner about four years ago for two reasons. That's when pharmaceutical companies released a new longer-acting insulin shot that freed her to eat on a more flexible timetable.

But she said the biggest change had nothing to do with wonder drugs. Rather, it involved a slow and very personal understanding of Philippians 4:11-13: "I have learned to be content with whatever I have. I know what it is to have little, and I know what it is to have plenty. In any and all circumstances I have learned the secret of being well-fed and of going hungry, of having plenty and of being in need. I can do all things through him who strengthens me" (NRSV). *

Today, she says, she is still the same diabetic she was yesterday. The difference is she has stopped asking God "Why?" and started appreciating diabetes' role in taking her from independence to humility and dependence.

"Sometimes faith is not victorious," Howard explained. "Sometimes faith is not overcoming. Sometimes faith is just `hanging in there.'"

* Bible texts credited to NRSV are from the New Revised Standard Version of the Bible, copyright[c] 1989 by the Division of Christian Education of the National Council of the Churches of Christ in the U.S.A. Used by permission.

Pam Mellskog writes on health topics from Lafayette, Colorado.