Disclaimer:
I am not a medical professional. I am a patient talking about what I have learned in my life by being the child and grandchild of Diabetics and from my 14 years of experience managing this disease for myself.
I also recognize that my experience comes from a place of privilege. I have health insurance that enables me to try all of the available medications, get all the supplies needed to monitor my blood sugar in whatever way works best for me and to have an insulin pump. I also have the ability to go to the doctor and look for a different doctor if that one doesn't work for me. I acknowledge that not everyone has access to these resources. I wish that wasn't true but it is. Some people with Diabetes have to eat whatever is available to them and don't have insurance to care for their disease. That is not fair. Our system is broken and I am always looking for ways to fix it.
I am a white woman of 100% European descent living in a big city in the United States of America. I recognize that this colors my experience.
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I talk about racism and sexism and ways they hurt us and how we can fix them. Here is another one we need to work on. What do we call it? Medical diseaseism?? Ok that is not a word. I don't know the word for othering people with a medical disease and feeling like we have the right to judge their behavior and their illness as a punishment for misbehaving.
That is what our society does to Diabetics.
What is Diabetes?
From the Oxford Languages dictionary:
- a disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbohydrates and elevated levels of glucose in the blood and urine.
When Diabetes was first discovered the doctor would taste the urine. It was diagnosed if the urine tasted sweet. Thankfully it is not tested that way anymore. Gross!!
I want to take this opportunity to educate my readers and talk about what is really happening.
First let talk about the difference between type 1 and type 2. What it is and what it isn't.
Have you heard of adult onset Diabetes and childhood Diabetes? Have you heard of fat people Diabetes and skinny people Diabetes? Those are not real things. There is type 1 Diabetes and type 2 Diabetes. I have also heard of type 1.5. What do those terms mean? It is really simple actually.
Type 1 = the pancreas doesn't produce any insulin at all. Insulin is necessary for the body to process sugar. Sugar is necessary for our bodies to function. So, a type 1 Diabetic has to take insulin or they will die. It used to be an automatic death sentence. Now, with proper treatment these people can live a long life. It used to be thought of childhood onset or skinny person Diabetes. It doesn't hit some people until they are adults. This is considered an autoimmune disorder.
Type 2 = the pancreas doesn't work correctly. The body doesn't produce enough insulin and/or the cells have become insulin resistant so the body doesn't process sugar correctly. There are a lot of drugs available for type 2 Diabetics. Most of them are new and it is really trial and error. Some of us use insulin. Type 2 Diabetes can also kill people. There is an epidemic of this disease. A lot of people die from it. It is accepted in our society for these people to be judged as fat, lazy, undisciplined and that it is their fault that they have this disease. It used to be thought of as adult onset or fat person Diabetes. More and more children are getting this disease. You don't have to be fat to have type 2 Diabetes.
Type 1.5 = this disease seems to start as type 2 but gradually turns into type 1 it is an autoimmune disease that appears slowly instead of suddenly. Recognizing this disease seems to be relatively new. No, I don't have this. I am type 2.
What is insulin and why do we need it?
From the Oxford Languages dictionary:
- a hormone produced in the pancreas by the islets of Langerhans, which regulates the amount of glucose in the blood. The lack of insulin causes a form of diabetes.
- an animal-derived or synthetic form of insulin used to treat diabetes.
After you eat a meal your body releases insulin. The insulin tells the cells to open up and let in the glucose. Whatever is not taken in by the cells is stored in the liver and muscles.
What is glucose?
From the Oxford Languages dictionary:
- a simple sugar which is an important energy source in living organisms and is a component of many carbohydrates.
- a syrup containing glucose and other sugars, made by hydrolysis of starch and used in the food industry.
What is insulin resistance?
Insulin resistance means that the cells won't open up and let the glucose in. That is bad. Our cells need glucose. Your cells running without glucose is like your house running without electricity or a a combustion engine running without fuel. Our brains use a lot of glucose. That is why it is hard to think if you are starving. So, a person who is insulin resistant can eat and still have a difficult time functioning. That is why you see type 2 Diabetics that are fat but they feel like they NEED a candy bar or a soda. Their brain is telling them...I can't function! Get me some sugar!!! So they do. And for a little bit they feel better and they think clearer. But because their cells are not absorbing most of the sugar they just consumed it goes to be stored in their liver and muscles. This leads to Non Alcoholic Fatty Liver Disease. That can lead to Cirrhosis of the Liver which has its own set of societal judgements. It is mostly believed to only be a disease of alcoholics. Alcoholism is an addiction. Our society judges addicts very harshly. So, a person with insulin resistance can get a disease which most people believe is only a disease of an addict and now they are judged as a fat, lazy, addict with no self control. They are dying and society is judging them for it.
I once had a sweet doctor lean in and look me in the eye and ask, "Are you sure you don't drink alcohol?" I was a practicing Mormon at the time and drinking alcohol was against my religion but because my liver looked so bad, she had a hard time believing me.
How do we cure Diabetes?
No one knows. Lots of people claim to know. I have tried a keto diet. My insulin resistance got worse. I have tried a vegan diet. It didn't work either. I have tried gastric bypass surgery. I thought that was going to work. I was actually released from diabetic care for a couple months. It didn't last. Not eating does seem to help but it is not sustainable. So, since we can't cure it the next question is...
How do we treat Diabetes?
This is a tough question. A lot of people think they have the answer. A lot of doctors think they have the answer. My experience is that it is not the same for every person. Each person has to try several treatments until they find the one that is right for them. And the really hard part is that a treatment can work for a long time and then quit working so they have to look for a new treatment.
It can appear that Diabetes is curable. Take my husband for example. He acquired type 2 Diabetes from taking Prednisone for another health condition. He was lucky in the sense that he quit taking Prednisone and the Diabetes went away. But he has to be careful because it could come back. He also seems to have a more difficult time processing sugar than he used to. So, I would not say he is cured. Another example is when my Diabetes seemed to go away for a couple months following Gastric Bypass surgery. I seemed cured. But I wasn't. You can treat your Diabetes so well that it disappears and never reappears. I don't call that a cure. I call that well controlled Diabetes. Because there is always that possibility that it could come back.
Like I said previously, for Type 1 Diabetes the only treatment is insulin. Unless there is some new discovery that I am unaware of. There are different kinds of insulin but that is what your body needs so, there aren't a lot of options.
For type 2 Diabetes there are lots of options and even more opinions.
Medication - it seems like every day there are new medications on the market to treat type 2 Diabetes. I have tried many of them. My body has trouble with lots of medications. I have had a bad reaction to every Diabetes medication that I have tried except for insulin. No one knows why. It is just true.
Metformin - this is the go to drug for Diabetes in our society. If it works then it helps a person's body respond correctly to insulin. It is great for some people if the problem is insulin resistance. It must work because it is so widely used. At least that is my thought process. I think it worked for me in the beginning. Eventually my confusing body started getting sick every time I would take it. So, listen to your body.
For a lot of people Metformin alone is not enough so they need another drug to stimulate insulin production in the pancreas. One example of this is glipizide. My body doesn't like that either.
There is another drug that I encountered as an injection. I think it was weekly. One of the ones I tried was called Bydureon. This sounds like magic to me. It is causes your body to make more insulin when your blood sugar is high. Isn't that interesting? I imagine it is awesome when it works. I tried 2 different ones. Each one caused me so much pain in my pancreas that I felt like I was going to die. Once I did go to the hospital. But, I am not the usual case. It works for a lot of people.
That leaves me with insulin.
Even with insulin you have short acting, rapid acting, intermediate acting, long acting and extra long acting. I have no idea how they do all of that.
Then you have injections or you have pumps. There is no way to get away from the needle.
I have a pump. Managing my Diabetes just felt too hard, so I have a pump. It makes things much easier. But I still have a lot to do to manage it. That is where I get in trouble with my Endocrinologist and they seem mean.
What is an Endocrinologist?
- a medical practitioner qualified to diagnose and treat disorders of the endocrine glands and hormones."he is a well-respected endocrinologist who specializes in treating both Type I and Type II diabetes"
