I originally started this post a few weeks ago after I read some comments about type 2 diabetes on the My Diabetes Secret Tumblr, along with various commentary about the recent New York Times article. It’s no secret that in the diabetes community, there is a schism between people with type 1 diabetes and type 2 diabetes. Sometimes it feels like we’re factions at war with each other (Divergent, anyone?). I was working on it for a little while, but then felt that the time had perhaps passed. But now I read that a conversation about diabetes misconceptions was held at last weekend’s Diabetes Sisters conference. I didn’t attend the conference, but that doesn’t mean that I don’t have something to say on the subject.
You don’t have to live long with type 1 diabetes to realize that there are a lot of people who don’t have a clue what life with diabetes is like. Whether it’s a complete stranger, your next door neighbor, or your mother, someone is bound to say something that isn’t only inaccurate, it’s also a bit cruel. People comment on everything from your activity level to your food choices to how you look and somehow it’s all okay.
Type 1 diabetes is an unusual monster. It carries some similar qualities another monster, type 2 diabetes, and yet it also has some very unique features. It isn’t the same disease, and yet the two are constantly conflated with each other in the media and with people outside the intimate D-circle of life. Because of this, we suffer through comments about causing our own diabetes (we didn’t), getting off our medications (we can’t), and well at least we don’t have cancer (… the hell?).
It’s no wonder people with type 1 diabetes are a little angsty about being connected with people with type 2 diabetes, when it seems that people have such a poorly formed idea of what type 1 diabetes is like. I can totally understand where the frustration comes from. After twenty years of living with diabetes and more than ten years of being deeply ingrained in the diabetes community, I’ve heard my fair share of stupid, misinformed statements.
But the surprising thing? The thing that maybe we as type 1 PWDs don’t want to admit? Is that there is a boatload of stupid, misinformed statements about type 2 diabetes, too. And those who perpetuate these stupid, misinformed statements is often… us.
Like Kerri mentioned on her blog post, I’ll admit that I haven’t always thought very kind things about people with type 2 diabetes. I was raised to think they were fat, old slobs. And while that is sometimes the case, it is by no means the only description for people with type 2 diabetes. In fact, it wasn’t until I attended a conference of the American Association of Clinical Endocrinologists that I heard a leading endocrinologist from New York share that there is evidence of twenty different kinds of type 2 diabetes. Twenty!
Later, when I was interviewing the president of AACE, Yehuda Handelsman, that I learned that people with type 2 diabetes needed to have the genetic component in order to have type 2 diabetes. It wasn’t as simple as just be lazy and obese, but that there were genes that played a role in the onset and development of type 2 diabetes.
Another stereotype I used to believe was that type 2 diabetes was easier to manage. Then I learned from a friend of mine with type 2 diabetes that when her blood sugar is out of range, there isn’t much she can do about it. Sometimes she goes for a walk, but she doesn’t have the option of just “shooting up” to bring her blood sugar down, and she has to stay with a more confined meal plan because, being on metformin only, she can’t take extra insulin to cover the carbs. When I was at an ADA Diabetes Expo a couple years ago in New York City, I was recommending snacks to some type 2 PWDs and was shocked when they said they had to stay around 10 grams of carbs.
The grass isn’t always greener on the other side. Sometimes it’s just another shade of crap.
It was these little nuggets of information that opened my eyes and realized that maybe I didn’t know as much about type 2 diabetes as I thought. In fact, our impressions of type 2 diabetes can be likened to what non-PWDs think about type 1 diabetes. We get so frustrated and so up in arms when people treat type 1 diabetes with simplicity, and yet we treat type 2 diabetes with exact same kind of simplicity that angers us.
Oh you just have to take a shot. Oh you just have to avoid sugar. Oh you just have to do this for the rest of your natural life.
At the end of the day, both groups are victims of assumptions, stereotypes and generalizations. We hate when the general public makes stupid comments about us, and yet many of us are more than ready to make the same kind of inconsiderate comments toward people with type 2 diabetes. And so type 2 PWDs at the end of the day are not only dissed on by people outside the diabetes community, but they are also verbally beaten down by us, people with type 1 diabetes.
What I hope people understand is that both types of diabetes deserve to be fully understood and respected for what they are. There are differences between the two types of diabetes — I’m certainly not arguing that — but there are also similarities, and for the time being, we are part of the same diabetes family. Even if we weren’t part of the same diabetes family, even if we were to suddenly have two very different names for each disease, that does not excuse the perpetuation of stupid, misinformed statements. Bad information is bad information no matter what you call it. While it is frustrating to have the type 2 stereotypes placed on the type 1 community, it is equally frustrating and wrong to have type 2 stereotypes in the first place. We are angry about something that we ourselves are contributing to.
Next time you feel inclined to make a comment about something that you don’t live with and don’t fully understand, I encourage you to remember how frustrating it is to hear comments from people who don’t live and don’t understand your life.