Diabetes - a 'lifestyle' disease?

[gewoff]

"What exactly do the diabetes charities spend their money on.....except for their fancy websites?
Raising awareness, lobbying and research Unfortunately, despite the prevalence of diabetes and the awful consequences, most diabetes charities receive a fraction of the donations that other charities e.g. cancer do This is largely because of the huge misconception that diabetes is solely a 'lifestyle' disease that people succumb to by being fat and lazy"

I was interested in the above quotation by Northerner on another thread, and it struck a cord.....

When I was first diagnosed with T2 back in 2008, I only told my immediate family, for the very reason that at that time, my personal perception was that my diabetes and particularly because it was T2, was my fault. And it probably was - I was overweight, didn't exercise, and ate much of the wrong stuff - as did the majority of the people around me.....

I'm a bit more relaxed about it now, but many of my friends still have no idea that my new svelt profile and trim figure(!), my regular daily walking regime, and healthy diet are anything more than a personal choice rather than a medical necessity. I still feel somewhat embarassed about it all.....

What do others think? Is our T2 our fault? Is Diabetes UK doing enough to counter misconceptions? What can we do to improve things? How can we better deal with any embarassment?

 

[Amberzak]

Honestly I feel the same way with type one. Because I inject people say 'your diabetes is so bad you have to inject, you must be unhealthy', or 'you have diabetes at your age? You must have eaten a lot of sugar as a kid'. Annoyingly, even nurses can be ignorant. There's a nurse at my church. I mentioned to her that I don't bother calorie counting because I have a hard enough time having to carb count all the time. She said 'you don't need to do that?' When I said 'well yes, I'm insulin dependent' she said 'well if you are healthier you wouldn't need to inject.' This is a nurse.

It is true that some type 2s is caused by lifestyle. Just in the same way as some cancers are, some heart disease and liver disease is. Doesn't mean that everyone who has cancer smokes, or everyone with liver disease drinks. I'd be interested to know how people with cancer or heart disease are treated by the public. Are they blamed for having the disease when it also might not be their fault.

To be honest, all the publicity etc seems to be type two aimed. It's probably not the best publicity I agree, but I've hardly ever seen anything aimed at type ones. I want to make an advert in which a young man looks like he's drunk. Because everyone ignores him, and no one helps him, he collapses, and on his wrist is a wristband saying he's insulin dependent
Hypo awareness for the public.

I'd also like to make employers more understanding. When I was training as a teacher, I was failed during an observation for 'eating a sweet while teaching' even though I said 'I'm having a hypo so just need something sugary'. They said I should have waited until the end of the lesson, apparently.

I also agree with you about keeping it secret. I can't unfortunately as hypos are too frequent. So I have a wristband on. But I don't vocalise it very often as people then usually start judging me on what I'm eating. I had someone once snatch a lucozade bottle out of my hand saying I can't drink it
I was in a hypo at the time.

 

[robert@fm]

I reckon that in many if not most/all cases, it's T2 that causes obesity, not the other way around. 🙄 What happens is that the body's insulin or insulin receptors are faulty, so instead of providing energy as it should, the glucose stays in the blood and the liver corrects this problem by converting it to fat. This continues until this coping mechanism is overwhelmed, at which point the glucose remains in the blood and the level rises until a T2 diagnosis is made.

The official scientific viewpoint is that "there is a link (exact nature unknown) between T2 and obesity"; of course tabloid newspapers, whose ethic is "as long as it's sensational, who cares about accuracy", inflate this to "obesity causes T2", which is a textbook example of the cum hoc fallacy. 🙄

 

[DeusXM]

Some great points here - Robert is bang on about the issue of obesity and I really like what Amberzak's said which hints at a deeper issue that's more than just obesity.

Diabetes seems to be one of those conditions where the general public regards itself as well-informed about yet actually knows next to nothing.

Everyone 'knows' you can't eat sugar EVER.
Everyone 'knows' it's your own fault for eating too much.
Everyone 'knows' that the more you have to do to manage it, the naughtier you must have been before.

The problem is that every one of those fundamental assumptions is wrong. Can you imagine for one minute someone slapping a cigarette out of the hands of someone with lung cancer or someone taking a pint off someone with liver disease? I can't - for some reason, people with conditions that have a high probability of being caused by poor lifestyle choices are trusted to make their own decisions, whereas apparently everyone with diabetes has such a fat, sugar-addled brain that we should be treated like children.

I genuinely don't know what the solution is. I sure as heck know it's not putting adverts on buses of people crying with the word DIABETES written in 500pt bold text and it's also not posting a picture of yourself on Twitter with the hashtag #freediabetics. The only thing I can think of it working hard to put out the idea that diabetes is actually really complex and complicated...but I worry that by doing so, it'll either get written off as 'oh look, the fat people are making excuses when they're just lazy' or it'll terrify people so much that no-one will ever go to get diagnosed and those who are new to this game will end up feeling more overwhelmed than they already are.

The best I can personally do is just get on with my life to the very best of my ability and show those around me an example that diabetes isn't a question of blame and it's also not something that stops you from doing anything.

 

[stephknits]

Great thread and interesting points. I too have been pondering what could be done about the lack of correct information out there. I do worry what people think when I am out in public and having a hypo (am a bit of a control freak). I have just signed up to the diabetes voices campaign which I hope will start to address some of issues. Will let you know how I get on.

 

[graj0]

What do others think? Is our T2 our fault? Is Diabetes UK doing enough to counter misconceptions? What can we do to improve things? How can we better deal with any embarassment?

I was diagnosed in 1997 and never felt it was my fault, my father, cousin and uncle were type II (only one was overweight) and my dear old aunty was type I.

However, my GP and the hospital dietician could not have thought it was my fault either, they wanted me to eat more carbohydrate, despite me thinking I ate too much and wanted to cut back and to lose weight, especially as I didn't eat chocolate, cake, biscuits (usual sugary things).

Took me 17 years to cut back carbs and get my life back on the right road, because I followed their advice.

None of my friends were judgmental either, just as well, they could easily be ex-friends now. LOL

 

[Sally71]

I have been lucky over the last two years and have hardly had any of these ridiculous comments, most people seem to be genuinely interested. I had an absolute corker today though!

I work as a relief midday supervisor at my daughter's school. A new T1 girl has just started in reception. Teacher did ask me a couple of questions in the first couple of days but hasn't since so I presume she's getting the hang of dealing with it now! But I was a bit concerned this week to find that we have no first aid information on this child in our file and that most of the midday supervisors don't even know who she is, even though we are four weeks into the term now. So I raised the question with my supervisor who immediately went to ask the teacher about it. The reply came back that we don't need to know about it, because the teacher tests her blood just before she goes into dinner and therefore she will never have a problem at lunch time! 😱😱😱

Aaaaaagh - where do I start?! Nobody actually checks whether the child eats all her dinner, so if she's bolused for 50g of carbs but only eats 10 then she could quite easily be hypo by the end of lunch time! And of course the rest of us are well aware of how D has a wonderful habit of throwing curve balls just when you least expect it. So although 99% of the time she probably will be fine, you absolutely cannot know for sure that the other 1% will also be ok...

As it happens, a friend of mine (mum of one of my daughter's friends) just happens to be a parent governor who has just been given the task of overseeing the school's introduction of the new policy of ensuring that all medical conditions are correctly looked after. I shall be having coffee with her on Monday morning... 🙄

I must add here that the way the school has dealt with my daughter is pretty much faultless, we have a good care plan in place, so far the teachers always follow it to the letter and are straight on the phone if anything happens that they don't understand. Midday supervisors in the junior school have her whole care plan in their first aid folder just in case they need it. Hopefully it will all get sorted for the little one too!

 

[happydog]

When I was diagnosed with T2 in September 2012 the doctor said "I don't understand this you are not overweight, active and have no history in your family. I am not sure that it is T2. His diagnosis was over ruled by the senior partner who would not allow any further investigation despite both my mother having chronic pancreatitis and my father cancer of the pancreas from which he died. I was shocked at the ignorance and lack of interest in the medical people that I came across. Thank goodness for this forum. It will be very hard to change public conceptions about diabetes while so much misinformation is dished out by the newspapers and television and GPs take so little interest. I know that there are exceptions to this thank goodness. We can all tell people the truth when they ask.

 

[KookyCat]

When I was diagnosed with T2 in September 2012 the doctor said "I don't understand this you are not overweight, active and have no history in your family. I am not sure that it is T2. His diagnosis was over ruled by the senior partner who would not allow any further investigation despite both my mother having chronic pancreatitis and my father cancer of the pancreas from which he died. I was shocked at the ignorance and lack of interest in the medical people that I came across. Thank goodness for this forum. It will be very hard to change public conceptions about diabetes while so much misinformation is dished out by the newspapers and television and GPs take so little interest. I know that there are exceptions to this thank goodness. We can all tell people the truth when they ask.

That's apalling Happydog, I don't understand their cavalier attitude really. Although I was told point blank by one GP that I had been misdiagnosed because it was impossible to get type 1 at 40. Frightening

 

[Andy HB]

I had a poor lifestyle prior to diagnosis. I was overweight and didn't exercise much.

At diagnosis my spot BG was mid-20's (I forget the actual number now) and my HBA1c was 13.3% (122mmol/mol).

Following diagnosis, I ate more healthily and consistently. I exercised more. Eventually going for a daily 1hr walk Monday to Friday and 90mins at the weekend.

From my peak weight prior to diagnosis (probably somewhere near 20st), I eventually got down to 13.5st (briefly) before stabilising around 14st.

Initially I was on gliclazide and then metformin. However, with the change in lifestyle I was able to come off all medication within three months. I have been off all medication ever since (coming up to five years now). My last HbA1c was my best since diagnosis (5.6% or 38mmol/mol).

So, please don't tell me that my lifestyle had nothing to do with my type 2 diabetes because I won't believe you! 🙂

Also, don't tell me that I was obese because of my type 2 symptoms either. Whilst that may have added to my problem just prior to diagnosis it was NOT the driving force behind me being overweight in the first place.

Oh, by the way, I believe that my type 2 symptoms had been building up for around ten years prior to diagnosis. I am also left with peripheral neuropathy with partial loss of feeling in my fingers and toes (and elsewhere). However, I am fortunate that whilst the feeling is reduced, I do still heal well.

In conclusion, I have never felt embarrassed nor treated like a child by anyone. I had a condition which I could do something about (and was fortunate that I could do something about). The diagnosis was the kick up the proverbial I needed to sort my life out (with no little assistance from the NHS .... I have nothing but praise for everyone who helped me).

The footnote to this story is that two years after diagnosis and when I was feeling so much better and healthier, I actually met someone via an online dating website. Well, in August this year we got married. That would never have happened if I had stayed as I was. 🙂


Andy 🙂

 

[robert@fm]

This is a great thread, lively debate and some interesting responses. 🙂

I was told point blank by one GP that I had been misdiagnosed because it was impossible to get type 1 at 40. Frightening

Surely GPs, who have had seven years of medical school, should be able to realise that type 1 isn't necessarily an autoimmune disease, but can be caused by anything which stops the islets from working, and hence at any age? 🙄 I've had no education to speak of, and even I know that...

 

[Sally71]

Grrrr.... What chance do we have in educating teachers, friends etc if even doctors can't get it right? 😡

 

[bill hopkinson]

I have never been a heavy eater and never drifted into the the obese category.
However, I have always had a sedentary job.
I think I developed insulin resistance because of lack of exercise.
Then, I believe, an accelerator kicks in. Once I have insulin resistance weight starts to climb.
I was diagnosed T2 in my most active job as a manager in a prison, lots of walking all day, but the accumulation of previous 30 years of sitting at a desk.

 

[KookyCat]

This is a great thread, lively debate and some interesting responses. 🙂



Surely GPs, who have had seven years of medical school, should be able to realise that type 1 isn't necessarily an autoimmune disease, but can be caused by anything which stops the islets from working, and hence at any age? 🙄 I've had no education to speak of, and even I know that...

You'd think wouldn't you 🙂. I was classically autoimmune too with severe parotitis that was very visible, and I was only just 40, so not really that far out of the classic "before the age of 40" description. Btw there's an interesting magazine article about a famous food writer diagnosed at 70 in one of this month's glossies so maybe the message is starting to get through. The same doctor also told me I'd need to lose weight to control my diabetes, I'm 6ft and I weighed less than 8 stone at that point, I just waited till she looked up and gave her my best disgusted look, that did the trick 🙂

 

[Andy HB]

This is a great thread, lively debate and some interesting responses. 🙂



Surely GPs, who have had seven years of medical school, should be able to realise that type 1 isn't necessarily an autoimmune disease, but can be caused by anything which stops the islets from working, and hence at any age? 🙄 I've had no education to speak of, and even I know that...

I always thought that Type 1 was specifically caused by an auto-immune response.

However, anything which causes the pancreas to stop producing insulin to all intents and purposes results in the same conclusion. That is, needing insulin injections.

For example, someone having to have their pancreas removed because of cancer, say, wouldn't necessarily be classified as Type 1?

 

[KookyCat]

I always thought that Type 1 was specifically caused by an auto-immune response.

However, anything which causes the pancreas to stop producing insulin to all intents and purposes results in the same conclusion. That is, needing insulin injections.

For example, someone having to have their pancreas removed because of cancer, say, wouldn't necessarily be classified as Type 1?

Mostly it is, pancreas removal is referred to as something else but can't remember exactly what (might be type 3?). There is a type 1b where the beta cells fail and there's no autoimmune reaction evident but I think it's mostly in South East Asia and they don't really know what causes it. Interesting stuff 🙂

 

[Amberzak]

Grrrr.... What chance do we have in educating teachers, friends etc if even doctors can't get it right? 😡

Totally agree. Some of the most closed minded people I've met who think they know better are medical professionals.

When I was diagnosed, I got told I must be type 2 because im too fat to be type 1.

 

[Bloden]

I had a poor lifestyle prior to diagnosis. I was overweight and didn't exercise much.

At diagnosis my spot BG was mid-20's (I forget the actual number now) and my HBA1c was 13.3% (122mmol/mol).

Following diagnosis, I ate more healthily and consistently. I exercised more. Eventually going for a daily 1hr walk Monday to Friday and 90mins at the weekend.

From my peak weight prior to diagnosis (probably somewhere near 20st), I eventually got down to 13.5st (briefly) before stabilising around 14st.

Initially I was on gliclazide and then metformin. However, with the change in lifestyle I was able to come off all medication within three months. I have been off all medication ever since (coming up to five years now). My last HbA1c was my best since diagnosis (5.6% or 38mmol/mol).

So, please don't tell me that my lifestyle had nothing to do with my type 2 diabetes because I won't believe you! 🙂

Also, don't tell me that I was obese because of my type 2 symptoms either. Whilst that may have added to my problem just prior to diagnosis it was NOT the driving force behind me being overweight in the first place.

Oh, by the way, I believe that my type 2 symptoms had been building up for around ten years prior to diagnosis. I am also left with peripheral neuropathy with partial loss of feeling in my fingers and toes (and elsewhere). However, I am fortunate that whilst the feeling is reduced, I do still heal well.

In conclusion, I have never felt embarrassed nor treated like a child by anyone. I had a condition which I could do something about (and was fortunate that I could do something about). The diagnosis was the kick up the proverbial I needed to sort my life out (with no little assistance from the NHS .... I have nothing but praise for everyone who helped me).

The footnote to this story is that two years after diagnosis and when I was feeling so much better and healthier, I actually met someone via an online dating website. Well, in August this year we got married. That would never have happened if I had stayed as I was. 🙂


Andy 🙂

Congratulations, Andy and Mrs Andy! I didn't realise you'd had a proper dbs happy ending. I just thought you were a positive guy who'd taken the disease by the horns, and whipped it into shape. You're an inspiration.🙂