rewrite this title Nick Jonas Opens Up About 20 Years Living WIth Type 1 Diabetes—On and Off the Stage

You may know Nick Jonas as the youngest member of the Jonas Brothers. Or from his acting roles on the Disney Channel. Or as a coach on the hit reality TV show “The Voice.”

But you probably don’t know that Jonas, 33, has type 1 diabetes (T1D), and that this November—National Diabetes Awareness Month—marks 20 years since he was diagnosed with the disease.

In an exclusive interview with Health, Jonas revealed the most important lessons he’s learned about living with T1D, and what it’s like managing the condition on one of the biggest Jonas Brothers tours ever, “JONAS20: Greetings From Your Hometown.”

Jonas was diagnosed with type 1 diabetes at 13 years old. While type 2 diabetes develops over time, T1D is an autoimmune disorder, often diagnosed at a young age, that prevents the pancreas from producing insulin, the hormone that regulates blood sugar.

Jonas said he didn’t know much about the disease at the time, and he remembers feeling scared in the hospital. “I didn’t know if I was going to be OK—if I was going to die or not,” Jonas said.

During those first few days after his diagnosis, Jonas’s doctors taught him how to live with the disease—and then it was right back to work. Jonas was already on his way to stardom; he debuted on Broadway at age 9, and he and his brothers had just signed a record deal. “I really wanted to be perceived as very grown and adult at a young age,” he said.

Advocacy quickly became a priority for him, because “there really wasn’t a person that I could look at at that time and say, ‘They’re living with this disease and they’re doing just fine,’” he recalled. Jonas shared his condition with the public two years after being diagnosed and co-founded the nonprofit Beyond Type 1 in 2015, dedicated to improving the lives of those impacted by diabetes.

Jonas said he felt a lot of responsibility for his T1D growing up. “I was really hard on myself initially, thinking that my glucose levels weren’t where I wanted them to be, thinking it was all on my shoulders,” he said. “I took a lot on myself. And then over time, I’ve gotten to the point where I do truly lean on others.”

That means being transparent with the people around him when he has a blood sugar high or low, and communicating what he needs, he said.

Jonas also said he has to be more vigilant with his diet now that he’s older. He’s more careful about his carb intake and has noticed that certain foods affect his blood sugar differently as he ages. “Your body just changes,” Jonas explained. “There’s no one-size-fits-all for management of type 1.”

He’s been able to take these changes in stride thanks to a close relationship with his doctor and the support of a continuous glucose monitor, the Dexcom G7, which tracks his blood sugar levels in real time. It notifies him about spikes or drops, monitors trends, and shares his data with family and friends on an app—something he said is especially important while on the road.

Jonas is no stranger to a busy schedule, but “this year has been pretty nonstop,” he said. The Jonas Brothers have been on tour since August, and before that, Jonas was starring in “The Last Five Years” on Broadway.

Amid the action, Jonas said there are plenty of times when he needs to make adjustments for a blood sugar high or low. During a recent tour stop in New Jersey, he felt a low coming on while performing, beginning to feel disoriented and lightheaded. He told his brothers to talk to the crowd and buy him some time, and went offstage for pineapple juice and fruit snacks—then came right back out to continue the show.

Beyond controlling his glucose levels onstage, Jonas also takes care of his mental health—an aspect of diabetes management people may not realize.

Constantly balancing blood sugar levels can take a psychological toll, a phenomenon known as diabetes distress, and research shows that people with T1D have a higher prevalence of depression and anxiety. Jonas said he’s reflected on moments of high-pressure or anxiety and has actually found that the episodes were linked to a blood sugar high or low.

“I would encourage everyone to just be a support to the people they have in their life living with this disease,” he added, “beyond just asking if they need a juice for a low or water if their glucose is high, but really thinking about how they’re doing from an emotional standpoint.”

Jonas has always had to consider T1D in terms of his long-term health—people with type 1 diabetes have a higher risk of developing eye problems, nerve damage, and kidney disease over time. But now, he has a 3-year-old daughter to think about, too.

“Every moment, every minute becomes more precious when you’re seeing it through the lens of being a parent and wanting to be around your child as much as possible,” he said.

That perspective has pushed him to make small changes to improve his daily health, whether that means taking vitamins and supplements or being more conscious of what he’s eating. But Jonas said he doesn’t go for “big, drastic changes.” Instead, he’s learned to take the pressure off and just do his best, every day.