This appears to be a painfully sensitive topic for some people, but after reading the entire thread, I need to share my thoughts. The wording of title (and even the original post itself) is unfortunate, and has caused hurt and offense. I was struck however, by the subsequent denial of any significant differences.
Yes we are all in this boat together, but just as we are not all the same age bracket or gender, neither are all of us dealing with the same type of diabetes. There are "types" because there are significant differences. Maybe not the right names, maybe not enough types, maybe not always well understood, but they exist for a reason. The names have changed over the last century: wasting disease, sugar diabetes, water diabetes, juvenile diabetes, adult diabetes, Type 1, Type 2, IDDM, non-IDDM, Type 1.5, gestational diabetes... probably far more than I have ever heard or would care to list.
It matters to me that the people around me understand the basics of diabetes, and that there are differences between Type 1 and Type 2 as best as we understand them today, as some of those differences are important. It also matters, because one more person better informed, is one more person who may be in the right place at the right time to say or do the right thing to help someone else with diabetes, if only they understood a little better.
If I am crashing low (or have determined from finger sticks or CGMS trends that I am headed low fast) due to an unexpectedly physically active day, I don't need a lecture on why I shouldn't eat or drink something with lots of carbs and/or sugar.
Yes, I need to check my blood sugar, sometimes in the middle of an unscheduled meeting. No it can't wait - I don't know if I am very high or very low, and proper, timely action can avoid worse problems if I test now. I will try to be discrete and do the stick under the edge of the table so you don't have to see.
If my pump has a problem that I can't fix at the office or if I drove to work (40 minutes) before discovering my meter isn't in my purse, I can't wait 8 hours before going home.
I choose to skip the office potlucks as it is just too darn difficult to guess how much insulin is enough (but not too much) for the mystery casserole to avoid a scary low.
I keep smarties and other candies in my file cabinet not because I am a candy-addict selfishly hiding them from you, but because the glucose tablets are too darn sweet and/or chalky. I really need you to not eat my medical supplies.
Now that I've shared a few recent conversations, I believe some of the problem in discussing diabetes has to do with definitions. What is a "disease" (or as I prefer to call it, a chronic health condition)? Is it the cause(s), the symptoms, the possible treatments or the end results?
As I consistently (and hopefully patiently) explain to anyone who chooses to comment inaccurately or negatively on diabetes in my presence, there are two major, very different biological problems which can cause some similar symptoms (not all) and some similar results/complications (not all) - if not managed to the best of one's abilities - setting aside the far less common causes outlined earlier, such as losing one's pancreas altogether.
I simplify my "diabetes 101" discussion as most people need to understand more about it , but are not going to listen for more than 10 or 15 minutes at best. However, if they raised the subject, they will get the basics.
/BEGIN AD HOC D-101 Training:
Generally speaking, it is classified as two types: Type 1) auto-immune disorder attacking and killing the pancreas insulin-producing islet cells, and Type 2) insulin-resistance, where the pancreas produces more and more insulin with less and less effectiveness.
Type 1s, not having any insulin, MUST inject insulin in some fashion. Going on a diet, exercising more, becoming a vegetarian, or taking some new exotic "miracle-cure" health-food supplement is not going to solve my health condition. Some of these things might be healthy for all of us. However, barring some future technology to regrow my non-functional pancreas cells AND turn off my inappropriate auto-immune response, I will take insulin the rest of my life. (Ironically, the one person most adamant about being able to "cure" my Type 1 was a Type 2 successfully managing his health with diet and exercise, along with some rice bran supplement he espoused.)
An overactive auto-immune system may also attack other endocrine glands, such as the thyroid or adrenal glands. There is a medical term for these related health problems, once you have three or more separate systems affected by attacks from your auto-immune system (which I don't remember at the moment). One of these medical conditions is Hashimoto's Thyroid; I'm waiting for my third, so that I can collect another fancy medical term for my medical records.
Type 2s MAY be able to avoid the use of insulin for some unknown length of time, through a combination of pills, diet, and/or exercise. This type of treatment is hard work, and requires a great deal of commitment. Depending on their particular regime, Type 2 may or may not appreciate a spontaneous spaghetti, pasta or pizza dinner, followed by the ice cream sundae or tiramisu dessert - no matter how much they appreciate the intention behind the surprise party you threw for them to celebrate an unexpected success.
If they have a regular exercise program, they CAN'T just skip it for a few weeks for that rush project, without serious impact to their health. People with Type 2 may also have a higher risk for having Metabolic Syndrome X, which includes high blood pressure, heart disease and other potentially fatal health problems.
It is possible in people with insulin-resistance (Type 2) for their pancreas to "wear out" and need to start using injected insulin. It is also possible for people with an overactive auto-immune system that killed their insulin-producing cells (Type 1) to develop insulin resistance.
We all have challenges to deal with, mine just happens to be Diabetes, Type 1. I choose to wear an insulin pump, not because I have to, or because my type is worse than your husband's or mother's, but because I am able to better match my insulin to my 24-hour base insulin needs, thus improving my chances for a long, healthy life and hopefully avoiding the long litany of possible complications resulting from uncontrolled BG that I can discuss in disturbing detail: (micro-)vascular failures leading to blindness, amputations, kidney failure, etc.
/END AD HOC D-101 Training.
If any of the above D-101 is essentially in error, please let me know and I will happily incorporate better information in my ad hoc training efforts.
Many of our concerns are shared; some are distinctly different. Information, education and understanding about the similarities AND the differences are important - for us, for medical professionals of all types (sadly), for legislators and health plan administrators, and for the general public.
I have nothing but respect for anyone living with any type of Diabetes, Type 2 or otherwise. When I'm here, I read all the forums, as I never know what I might learn, or when I might be able to "pay it forward" and help someone else.
Best regards to all of you who made it all the way through to the end of this essay.
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