Crossing the Great Divide
Finding common ground between type 1 and type 2
By Wil Dubois
Great divides in history:
The Continental Divide.
The Mason-Dixon Line.
The Houses of Capulet and Montague.
The Atlantic Ocean.
Communism and Capitalism.
Lions and hyenas.
Type 1 and type 2 diabetics.
Well, to hear some people tell it, the differences between the two primary types of diabetes ranks right up there with the great divides in history.
May I please go on record as saying that I think this is a total crock of $#*t?
OK. I guess some background is in order before I dress up like an umpire and try to settle this once and for all. Type 1 diabetes is an autoimmune disease that sneaks up on you like a panther in the night and pounces on you with no warning. The body's own immune system turns on the home team and destroys the insulin-producing cells in the pancreas. Our best scientific minds aren't really sure what causes it. All we know for sure is that we can't prevent it, and nothing the victim did or didn't do had any hand in it.
Type 2 diabetes is a hereditary disease whose onset is triggered by a magic combination of age and weight. It's characterized by insulin resistance. The body makes insulin, plenty of it, but it can't use it very well. The latest evidence suggests that if you treat type 2 aggressively early on you can delay it, but it does not appear to be preventable. And like type 1, the victim of type 2 has very little culpability in causing the disease. At worst, poor nutrition and low activity might start the clock ticking early, but that's about it.
So from the pathophysiology perspective, the two diseases couldn't be more different. But from the human perspective, they're very much the same. The bottom line is that both diseases make it difficult to keep blood sugar in control, and having high blood sugar is like having battery acid in your bloodstream.
Both type 1s and type 2s share many of the same medications for treatment and gear for monitoring, along with many of the same risks to their health and well-being. People with both diseases also share the same hopes, joys, and fears.
So why the divide?
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My diabetes is changing. Until a few years ago, my morning readings were reasonable and within the desired range of under 100 mg/dl. About two years ago, they started slipping upwards into the less-desirable but apparently not-worrisome range of 100-110 mg/dl. Now, this was what was recorded by my Abbott Freestyle Lite meter, which is known to record at the lower end of the home-glucometer variability range, but with my A1c firmly in the high 5s and low 6s, the meter's tendency to...