Diabetes Stigmas and Struggles Part 1
Are type 1s treated with more respect than type 2s? What are options after two bouts with lactic acidosis? Is switching insulin types beneficial? This is part 1 of the column which highlights a few of the many questions posed by dLife readers.
Dealing with the Type 2 Diabetes Stigma
Question: Most articles about people with type 2 diabetes are "obsessed" and pay little importance in terms of the severity of the disease. Type 2 diabetics get a bum rap that it's our fault, that we are all fat and thus brought it on ourselves. On the other hand type 1 is treated with respect because it is never associated with words like obese or fat. Type 1 or 2, it is still a disease, is it not? I get so depressed when reading how to deal with the disease only to find it suddenly slips into the finger pointing and segregation of the disease by type. Am I imagining this? Should I feel ashamed? Do others feel my pain?
Answer: No, no, and yes. Many people share this feeling of being stereotyped based on their type of diabetes. Labels are useful on food products but problematic when used to identify people by their disease. The medical community uses them to help understand the underlying pathophysiology. Some unenlightened individuals will make insensitive remarks about the trend of obesity associated with type 2 diabetes. The majority of people in the U.S. are obese, yet not all overweight individuals have diabetes, and conversely, not all people with type 2 are overweight, nor all type 1s have ideal BMIs. Maintaining a healthy weight is a national struggle. Any diabetes professional worth their weight would not point a finger. Weight loss, for those who need to rid some extra pounds, is one of the "controllable" factors (easier said than done) that make a significant impact on diabetes management. We beat this common sense concept into the ground. Type 2 is serious and the researchers are working at warp speed to understand how best to understand prevention and treatment options.
In terms of the medical community not perpetuating the diabetes stigma and giving more respect for type 1s, I can only speak for myself. Typically, people with type 1 have had many more years in dealing with the disease and are tasked immediately to think like a pancreas. The struggles are different from those who have a gradual onset of type 2, yet the self-care behaviors are universal. Treating a person as a person first, partnering with them no matter their diabetes type or degree of self-management success, and showing respect and compassion for their path and their truth is key. If you have not found someone who will pay you that respect, shop around.
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I no longer wear an insulin pump. Nor do I wear a CGM. I wish the latter were different, as I think a CGM would be quite useful, but the welts that it leaves on my skin - in spite of multiple efforts to fight that welts - are just unacceptable. I am, however, still interested in when people remove their pumps and why. I've seen some recent discussion around folks being asked to remove their pump for mammogram procedure, so I figured I'd ask around the hospital I work to...