A group of people put their hands together in a huddle.A colleague at Bruce Bustin’s job gave him quite a surprise a few years ago when Bustin told the coworker that his diabetes had changed, and now required insulin shots.

Without a word, she reached into her bag, pulled out a sterile glucose pen of her own, and stuck Bustin in his leg.

“How was that?” she asked.

“That wasn’t so bad,” he admitted.

Adjusting to diabetes can come in stages, and Bustin has been through several. First, while working at a residential center for teens in 2003, he was diagnosed with Type 1 diabetes. Initially, he and his doctor were able to control the condition with a combination of diet and glucose pills. When Bustin’s pancreas began producing even less insulin a few years later, he realized it was time for insulin shots.

That was a second adjustment–but he handled it, thanks in part to that demonstration by the coworker.

A third change came after a year or so of glucose pens and needles, when Bustin moved on to wearing an insulin pump. That was a bit of a struggle, he admits, because of the discomfort of the pump’s needle. Bustin now uses a combined meter and pump–a fourth change–with a smaller needle, which he says is easier.

Each new treatment has required an adjustment.

“I do what I need to do to take care of myself,” he says.

Adjusting to all of life’s challenges has been an important part of Bustin’s life. Raised in Muskegon, after high school he joined the Air Force for a four-year tour of duty before returning to Michigan to marry his high school sweetheart. They now live near Grand Haven, and are the parents of two boys in high school.

In 2006, looking for a stronger professional challenge, Bustin returned to school to earn a master’s degree in social work. Now 48, he’s a social worker for the Grand Rapids Public School system, working with teenagers and young adults.

Bustin acknowledges that the challenges of having diabetes don’t go away.

Certain times of the year are more difficult than others. As with many people with diabetes–and others who are just trying to be careful about their diet–the holidays can be a struggle because of the proliferation of big, carb-loaded meals and plates of sweet treats.

“I have to focus and make sure I’m checking myself,” he acknowledges.

In his case, summer can be difficult, too, because school is out, and his workload–usually filled with a tight schedule of appointments, meetings and other specific tasks–is reduced. During the school year, Bustin uses the discipline of that tight schedule to keep himself focused on personal care.

“When I get out of my routine, that’s when I really struggle,” he says.

Last summer, in addition to his own lighter workload, a personal family tragedy shook him–the death of a close relative.

His A1c level, a measurement of glucose in his blood’s hemoglobin, had crept up as the summer approached. Although his sister-in-law had died of medical problems not related to diabetes, her death caused Bustin to reflect on his own health.

“I’ve got to take care of this,” he realized. “I said to myself, ‘I’m a diabetic, and if I don’t take this seriously, there are a lot of complications.’”

His self-warning helped him significantly–by autumn, his A1c level was back to normal.

To those who are recently diagnosed, or even those who are long-time diabetes patients, Bustin suggests that occasional self-reminders can help one stay on track.

“You have to get serious about this. Anything you can do now to ward off complications later is the way to go.”

Bustin said he tries to offer the same kind of team support in his job that he gets at Spectrum Health, where he’s been a patient for years.

“They go out of their way for you,” he said. His Spectrum endocrinologist’s office has a clinical social worker, “and I’ve used that service. That’s very helpful. I don’t know of any other practices that have that service.”

Along with millions of other Americans, Bustin found relentlessly severe winter difficult to endure. He wanted–and got–advice from several of the diabetes professionals at Spectrum to push through that unpleasant season.

“I feel like I have a huge team” at Spectrum, he says. “That’s very helpful. When you click with someone, you don’t want to disappoint them and don’t want to feel like you’re letting them down.”

The same philosophy applies to his job. Bustin said he tells teachers in the school district, “You’ve got to have a relationship with your students.”

Bustin reminds everyone with diabetes–and himself–that teamwork can lead to success, along with a willingness to make those occasional adjustments to the challenges of this condition.