Which is worse t1 or t2? Keeping another myth alive.
Wow, I am late to this discussion, but felt it worthwhile to join because it appears the debate continues...
Last month Diabetes Health published "What People with Type 1 Diabetes can Learn from Type 2s" by Clay Wirestone It set off a firestorm of comments, mostly from type 1s, about how dare you tell us we can learn something from those lazy, fat type 2s!
David Spero, blogger over at Diabetes Self Management then wrote this post, "Type 1s Vs. Type 2s?" calling for type 1s and type 2s to come together for the sake of our health and that both sides are not fully aware of what the other side lives with. Interestingly, the comments posted on Spero’s site were almost unanimously empathetic.
It seems to me, Wirestone’s biggest goof was his argument (that t1s can learn from t2s) and his tone. If he’d approached the topic from the point of view that t1s and t2s share some commonalities and we can each learn something from each other, the war may have never ensued. But it is a fascinating study in how we all emotionally hold diabetes.
You should go read the stories and comments to both stories. In reading all the comments to Wirestone’s post, I found Allison Blass nailed it for me:
"The problem with this article isn't so much that it's saying people with type 1 can learn something from type 2, but assuming that people with type 1 aren't already learning these lessons for themselves. Plenty of PWDs with type 1 exercise regularly, take their medication faithfully, and make small changes to get healthy. These aren't genius concepts divined by the type 2 community.
I will say that the amount of misinformation and misconceptions about type 2 diabetes in the comments are disgusting. Type 2 diabetes is not CAUSED by obesity - it's a contributing factor. Type 2 is not cured through diet and exercise - it is managed, just like insulin. Type 2 diabetes does not have the same flexibility as type 1 - blood sugars have to be dropped through extra exercise or changes in diet, not just a simple bolus. People with type 2 diabetes can go years without being diagnosed, which means that many people with type 2 are diagnosed at the same time they find out they have complications.
Type 2 diabetes is a bitch, same as type 1 diabetes. And yes, they are different. But we both have to do things that are different, we both have a health issues and learning tactics and strategies for handling certain situations could help.
In any event, if you don't like people spreading misconceptions about your disease, you should probably be damn sure you're not spreading misinformation about someone else's. It's not nice."
-Allison Blass www.lemonade-life.com
And then, as I said, even tho I came late to the game, I felt compelled to add my own 2 cents worth and so I posted this today on Spero’s blog:
"As a type 1 for 38 years I understand the cry of type 1s that no one understands how hard and intense it is to live with this disease, and that we are grouped under the same umbrella of those lazy, fat type 2s who did it to themselves.
Yes, many type 2s engaged in poor health habits that may have led to their diagnosis, but not all. One in five are slim actually. For some the genetic component is so strong they would have gotten it regardless of their actions. And there must certainly be type 2s who are annoyed with the bad press their own brothers and sisters bring them.
But one diabetes being worse than the other? It's all a matter of perspective. I wrote a book recently, "50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It" and the myth I always quote is, "Type 2 diabetes is not as serious as type 1."
It is one of my favorites, because the emotion runs so high and because the answer seems so obvious, but is not. Both are extremely serious because they can both lead to the same devastating complications. While type 1s will never get off their insulin, and endure more intense management, type 2s are asked to undertake preventive behavior, which anyone can tell you, is a bitch.
Since most type 2s are diagnosed years
after they have the illness, many already have complications by time they're
diagnosed. And while most type 1s will live with their illness longer than type
2s, many will also live more healthfully with it because they developed healthy
habits earlier and they see more directly the positive result of healthy
Since most type 2s are diagnosed years after they have the illness, many already have complications by time they're diagnosed. And while most type 1s will live with their illness longer than type 2s, many will also live more healthfully with it because they developed healthy habits earlier and they see more directly the positive result of healthy habits.
When “What People with Type 1 Diabetes Can Learn from Type 2s,” appeared on Diabetes Health what incensed most readers was the cavalier notion that type 1s aren't doing good enough, so obviously we could learn a thing or two from type 2s. That reeks of presumption and offends.
We all have something of value to share from our experiences, and it's up to us as individuals how we manage our diabetes. And, how we choose to see it - some see themselves as victims and only see hardship, others see diabetes as a welcome wake-up call and get healthier, and others see diabetes as a signal that life is precious and go about making the most of it.
Since no one can argue with your experience, it's foolish to throw rocks at someone else's. And while personally, I would vote to change the names of type 1 and type 2 diabetes to better reflect the differences and educate the general public about the differences, when it comes to helping each other out, let's not overlook that living with any chronic disease we share many similarities."
What's your take on this?
Diabetes Sisters was started just a few short years ago by Brandy Barnes, to bring women living with diabetes together and break the isolation so many of us feel.
As Brandy opened the event Saturday evening she said she couldn't believe how quickly she was seeing her dream come true as she looked out at the 100 faces staring back at her.
For there we were: type 1s, type 2s pretty evenly divided, and all ages from early twenties to eighty. I talked with 80 year old Liza, who got type 2 diabetes three years ago and I only hope I have her vitality, and her looks, when I'm 80! Women also came from both the local area and as far away as California, Illinois, New York and Texas.
The event kicked off Saturday night with dinner, socializing and a pampering treatment: massage, nails, hair or make up.
Sunday former Ms. America and diabetes advocate, Nicole Johnson, gave a truly inspiring talk. She developed type 1 diabetes at 19 and went on, against the wishes of many around her who thought it would be too much for her, to win the Ms. Virginia and then Ms. America title.
While she is beautiful, her talk - warm, funny and personable - showed she is beautiful on the inside too. And while there was probably no other beauty contest winner in the audience, I think we could all identify with the limitations she talked about that others often put on us and that in mass we turn that around to show just how capable and remarkable each of us is.
The day continued with a host of informational lectures from keeping your heart healthy, feeding your body, mind and spirit and dealing with body image to having a healthy pregnancy and going through menopause. Sheri Colberg was our ending key note speaker and she shared from her book secrets of the longest living people with diabetes.
As much as we came together to bond, celebrate and learn, it was also inspiring for me to see what Brandy had created bringing us together, and the uncompromising support she appears to have from her beloved type 3 husband and sister.
There's another "Weekend for Women" in the works for next year and it may even happen sooner than expected. If you'd like to participate you might want to stay current on the Diabetes Sisters web site.
How would I handle this kind of freedom - pie everyday?
Hmm...maybe it wouldn't be so bad, after all. But I do seem to have my eyes closed, like a blind person in this new world
Today, the last of diabetes blog week, the task is to pretend a cure has been found. We are all given a tiny little pill to swallow and *poof* our pancreases are back in working order. No side effects. No more insulin resistance. No more diabetes. Tell what your life is now like. Or take us through your first day celebrating life without the Big D.
Blog about how you imagine you would feel if you no longer were a Person With Diabetes.
I realize what a huge shift it is to think of what my every day would be like if diabetes were not in it: To eat without a second thought about what I’m eating and how many carbs are in it and how much insulin I have to load in my syringe. That seems the biggest technical change that would occur. Also, to not stab myself with needles – both for taking insulin and testing my blood sugar - a dozen times a day or see blood sugar trails in my kitchen and on my clothes.
To not have lows, but get through a string of days, geez every day, without feeling my heart beat out of my chest or that I HAVE TO EAT to save my life. How I hate that.
To not have to get up in the morning - no matter what the time - jump out of bed (usually 6:30 AM) and test my blood sugar so I can take that first injection to blunt my early morning rise. Of course that's followed by a bolus for breakfast and a basal shot for the day.
Three injections before 8 AM, no more. Sleep, with nothing hanging over me. Now that’s a sweet dream.
I seem to be caught up in what wouldn’t be. For it's so hard to imagine what would be if I no longer had diabetes. So hard to nail after 38 years.
While you know the score - every day is a new day you have to manage your food, exercise, insulin, emotions, time and activities, the daily ongoing chore of doing this has long been my life - it's just what I know after all these years. To rewind to before what has been two-thirds of my life is a distant memory. To fast-forward to not having diabetes is like a sci-fi-like imagined future.
And since, for the past seven years my work has been diabetes, thinking of life without it conjures up a multitude of feelings:
1) Who am I? Diabetes has lived with me for almost 4 decades
2) Yikes! What the f_ _k am I going to do for a living?!
3) Whewwww - the sound of every short-term worry and long-term fear slipping off my shoulders
4) I’m just like everyone else. Hmmm.. is that a good thing?
5) I’m leaving this space blank for when it really happens.
After all, I've been hearing for years it's going to happen any minute now .
My first medic alert bracelet after 37 years with diabetes.
Holding onto pride helps living with the d
You met him Wednesday - my biggest supporter
The beginning with type 1 at 18 years old in my dorm room
Winner of Eli Lilly's"Inspired by Diabetes" contest, 2008
Qantas bathroom bin flying to Sydney. How cool is this?
My emotional coaching book is in English and Spanish
My book agent lives nearby
That hurt like crazy going in!
Giving away 2000 books at the IDF conference in Montreal 2009
Every day you already are one even tho you don't think so
Today's blogging event is to show snapshots of our diabetes-life.
Of course, I could have pulled every photo that I have since every moment is also a moment with diabetes.
But then my computer would have crashed - for sure.
Suffice to say, these will take you a bit around my world: my life and my work.
Sometimes it's a bit much that my life and my work are so intrinsically linked.
Other times I feel blessed that they are after searching half a lifetime for my purpose.
Sort of depends what day it is.
My route around the park
Walking along the perimeter
Me and my Prospect Park
As part of our continued town-hall blogging this week, we're tasked with writing about exercise. If you've been here before you likely know I'm addicted to my daily power-walks. I stroll out of my apartment building most mornings, walk along two blocks - that's streets to anyone not from NYC - and a huge park awaits me that I walk around.
Most days I walk around the perimeter of the park rather than in it. I save that for weekends when I'm swept up in all the walkers, joggers and bikers. But during the week I enjoy the leafy trees and the brownstones along the streets that hug the park. All tolled it's about 7,235 steps around the park, 3.7ish miles I figure.
A few days a week I might walk not around the park but to do an errand. I walk to Trader Joe over in Brooklyn Heights, the library, a great middle-eastern market and through half of Brooklyn to buy discount produce. Luckily living in a city like mine, I can walk almost everywhere - including over the Brooklyn Bridge into Manhattan which takes me 77 minutes or so, not that I'm anal.
I've even been walking with an injured toe - it's got a hairline fracture. And, yes, I'm in a soft surgical shoe. But once I felt I could manage more than walking from my living room to my computer - all 5 feet - I took again to the streets.
Do I go low walking? Sure, sometimes. It's not an exact science: how many carb grams for how many steps. You can walk everyday the same walk, eat the same pre-meal, take the same amount of insulin yet your body doesn't seem to know it.
I carry SweeTarts all the time. They're in every pocket and bag and half are way beyond their expiration date. I find this out when I have to resort to a roll and it's stale. But, hey, at least it's there and still works its magic.
There aren't many other forms of exercise I do because there aren't many other forms of exercise I like well enough to keep up.
But walking: I walk because I am. How nice to slow down the world, see the trees, feel yourself breathe, let your thoughts ebb and flow and know you're burning calories and helping your insulin work better!
I walk because I am. I walk because I can.
It’s day 2 for me (day 4 for those who started diabetes blogging week when it officially began) and today’s topic is “To carb or not to carb.”
Ever since reading Dr. Richard Bernstein’s book, “Diabetes Solution” more than 10 years ago, I vacuumed white carbs out of my diet and that’s where they remain -- most of the time. I am no angel and I am human.
I often say I follow a low-carb diet, but that really isn’t true: vegetables, beans and my morning oatmeal make my daily food intake plentiful in carbs – just not refined carbs. I actually wrote about this in a Diabetes Health article, “The Debate Goes On: Carbs In or Carbs Out?”
I don’t eat low on the carb totem pole to be a martyr or anyone’s saviour, but for three reasons.
Reason #1) Since I've been eating this way my blood sugar rarely swings between bungee jumping highs and lows from the spike and fall induced by ring-dings, white rice and chips. My breakfast (recipe below) is my high carb meal, my lunch usually a salad with last night's veggies and some feta cheese or turkey, my dinner usually fish or chicken with veggies and beans. Working from home I have the luxury to do this. And just as important, don't have the typical office-meeting-leftover-danish around.
My healthy snacks are slices of turkey, nuts and fruit. I also adore Asian sweet potatoes - especially cold. They're the ones that are red skinned on the outside, more yellow than orange inside and more nutty than sweet. I snack on these too.
My less healthy snack, OK, unhealthy snack, is marble halvah with pistachio nuts. I'm addicted and I live near a great middle eastern market. I also love Lindt chocolate and I'm actually buying that chocolate's anti-oxidants make it a healthy snack. I eat a piece of 85% and 99% together. I know, I know... My sister in law brings me the 99% from Holland. Eaten together they average out at a perfect 93%! Now if only Lindt would make 93% chocolate and save me all this trouble! But I guess going through this exercise makes me very aware I'm eating chocolate and helps me keep my intake to one or two pieces - usually.
Lest you think I'm a paragon of virtue there are those days, and nights, I can eat every darn thing in the house. That seems to follow a tough day or boredom or my husband having just flown off to Holland again.
For a while now I've been looking at what I eat as medicine and when you make that shift it's much easier to put healthy foods in your body more of the time. I've long joked my wine - a glass or two most nights with dinner - is medicine since it lowers my blood sugar. In fact, I often don't need any insulin at all to cover dinner if my dinner is pretty low carb and a nice Rioja accompanies it. When my blood sugar is below 100 mg/dl before I go to sleep, I eat a few bites of an Extend bar to safely keep my blood sugar level throughout the night.
Reason #2 I eat this way) If I ate more carbs, as in the refined stuff – pretzels, sandwich bread, pizza, muffins – I’d have to use more insulin. Having watched a friend once inject 43 units for the same lunch I took 1 unit for, (granted he is a type 2 and insulin-resistant) I will do my utmost to stay insulin-sensitive.
Reason #3) I think it's just been drummed into my head how important blood sugar control is and I find it so much easier to have that control when simple carbs aren't part of my diet, that I've made the sacrifice. Although what was once a sacrifice, doesn't feel like one anymore. I don't miss white bread, rice, potatoes, pasta. While I gave up pasta for almost two decades, I now eat Dreamfields pasta which has only 5 carbs/serving. Sometimes other diabetics look at me like how can I do this? But I've had 38 years with diabetes to change my eating habits.
Also, for me, feeling good about my control is more satisfying than the momentary taste of things I no longer crave. And having A1Cs consistently in the high 5's means a lot to me given the first dozen years I had diabetes there were no meters and when there were, my blood sugars were consistently around 200 mg/dl. I'm sure my cleaner carb scoreboard these days is an effort to make up for those lost initial years.
Last but not least, we can’t escape this truth: routine makes diabetes more manageable. Since I tend to eat similarly most days of the week, I tend to know how much insulin I need to cover what I eat. And that makes my diabetes-life easier.
Just a few weeks ago I finally kicked a habit I've been trying to kick for years. I said "Enough!" to artificial sweeteners. Like someone who's tried to quit smoking and it took five tries, that's me with artificial sweeteners. But I'm clean now and I really know I'm done. After all, how can I do what I do to be healthy and keep putting chemicals in my coffee, tea, hot chocolate etc? So I kicked the sweet n' low, Splenda, Equal cold turkey. Even Truvia is gone. I think the power actually came reading "The End of Overeating" and realizing that if you keep feeding your sweet tooth, even with artificial sweeteners, you keep your tastebuds lurking for sweets.
Tis true, I am very disciplined; it just works for my Virgo self. Just don't listen to my friends who will tell you they have seen me fight over a plate of fried calamari, Maryland crab cakes, peanut butter cookies and the gingerbread my bakery around the corner makes.
Give it a try - my indescribably delicious high-carb breakfast.
Riva’s Oatmeal: Ingredients & Preparation
Put in the bottom of a cereal bowl:
1 tsp raw sunflower seeds
1 –2 Tbs ground flaxseeds
1/4 Granny Smith apple cut into bite-sized chunks
1/4 cup berries
Add 2/3 cooked serving of steel-cut oatmeal. Mix all ingredients together
1 Tbs non-fat cottage cheese
1 Tbs Fage (Or Equivalent Greek) 0% Fat Plain Yogurt
1 level Tbs Creamy or Crunchy Natural Peanut Butter
1 level Tbs Raw Natural Almond Butter
Given we all seem to exist in internet time now, it should not surprise me how quickly great ideas arise and happen. I just read Amy Tenderich's post on DiabetesMine and heard I'm already late to the party, but still invited - to Diabetes blog week.
Karen from Bitter-Sweet blog has opened a door for readers who follow our diabetes ramblings to hop around the community (Left hand side of page: Recent posts from diabetes blog week participants) and read what we have to say about the same 7 topics this week. Since I'm joining the group late, I've missed musing about, "A day in the life...with diabetes" and "Making the low go." But I'm up for today's topic, "Your Biggest Supporter."
It's funny that this should be today's topic because just these past few days I've been feeling a little unthrilled with my diabetes. Mostly I think it's because not only do I, like you, live with diabetes 24/7, but I also work in diabetes. That sometimes makes diabetes feel like a 36/7 affair.
And, actually, as Amy mused, since I typically manage my diabetes well, when I'm feeling off my game, getting that 278 blood sugar out of nowhere, yes, that happened the other day, or not wearing my happy-diabetes-face, I feel like I'm letting others down. After all, how can you be a role model (which my perfectionist Virgo self takes to heart) of health and be an ordinary human too? I guess that's still a lesson in progress for me.
That said, on to today's topic. There's no doubt I wouldn't be able to live as I do and take so much in stride if I didn’t have support. Support for me comes from many places - close friends who ask about my diabetes and do things like change the time we'll all gather for dinner to accommodate me, my mother who keeps one ear to the ground clipping anything she sees about diabetes and posting it to me and my diabetes friends whom I can talk to anytime about anything diabetes and they get it - they live here too.
But I want to tell you about my biggest supporter. It is without doubt the same creature I imagine most people would annoint, their partner. In my case my husband. When I slip out of bed in the middle of the night he calls out, "Are you OK?" Some mornings when I'd rather not get out of bed he walks into the kitchen, lifts my meter from its resting place and brings it to me so I can test.
When we were in Sydney last Christmas visiting friends, all of a sudden I felt low. I tested and discovered my blood sugar was 39 mg/dl and sweat began to pour down - his face! "What do you need?" he implored. "Get 1/2 a glass of juice from the refrigerator" I said. He bounded down the steps, three at a time, and ran back up them with twice the amount of juice requested, himself shaking while I drank, watching till the color returned to my face.
When he accidentally lost my meter while we were in Finland one summer, which we only discovered at midnight when I was ready to test my blood sugar before bed, over my protests he ran out into the midnight sun to the only all night drugstore open in Helsinki to bring me back a meter so I could test. On the occasional walk we take together he has SweeTarts in his pocket should I go low and while he wants to fix it when I have the diabetes-blues, he still listens and lets me know he understands.
Of course, none of this surprises me. Almost ten years ago when we were engaged I said to him one evening, I want you to know that you can back out now. Life with a diabetic is unpredictable. I don't know what's going to happen to me and what that will mean for you. After my speech, he wrapped his arms around me and said, "I'm with you now and you're with me. That's all that matters."
I should add one other note. It's my husband's support, on every front, that allows me to do this work. Hmmm...come to think of it, maybe I have him to blame for diabetes sometimes seeming like a 36/7 affair! Maybe I need to rethink this entire passage. Nah, truthfully no other work would be as fulfilling and no other person would understand that.
I joined the American Association of Diabetes Educators (AADE) last year. I wanted to better understand what they discuss, what's difficult working with patients, and how they are successful. I get lots of notices about web seminars but in truth I haven't taken any, primarily because I'm not looking for credit. I'm a "diabetes educator" by way of being a well educated patient and sharing my knowledge in books and presentations, but not working with patients in a clinical setting.
I get the quarterly newsletter, however, and it's interesting to read what our educators read and see patient management from their perspective. There's still the occasional talk about "compliance," but there's also talk about how to ensure illiterate patients understand what they need to to manage their diabetes and sharing knowledge and experience among the AADE membership.
Skimming through the Spring 2010 AADE in Practice newsletter, I stopped to take this in in their Practice Pearls section. Kathy Dropeski, RN, BSN, CDE writes in "In This Place-A Promise To Our Patients," that sometimes patients are fearful and dread a meeting with an educator, conditioned by years of judgmental glances and their apparent failure to adequantely manage their diabetes. Don't we know it.
She advises educators create a sanctuary of safety where patients have the freedom to learn, ask questions and grow in managing their diabetes. These are words she found inspiring to remember:
In This Place - A Promise To Our Patients
In this place, you will not be judged by the numbers in your logbook.
You will be valued as a whole person with dreams, goals, aspirations and responsibilities.
You will be respected as an individual who has a right to make your own decisions and choices.
You will have the freedom to falter, to make mistakes, and to try again as many times as you need to.
You will be empowered to set goals, to make decisions and to take actions that will help you make the changes that you want to happen.
You will be encouraged to ask questions, to test our knowledge and to challenge us to grow in our ability to serve.
You will have educators (teachers, coaches) who will stand beside you as you learn to live with a disease called diabetes.
If you're a diabetes educator you might just want to print out a copy and post it where both you and your patients will see it. Actually it's not bad advice for any health care provider, diabetes or no diabetes, teacher, parent, partner... you get the idea.
Just where I was bomb night
Saturday night I was exactly where Faisal Shahzad had just run away from. Smack in Times Square. I was with my husband and we were meeting a colleague of his for dinner who had just arrived in town from Holland. She was staying at the Grace Hotel on 45th street and 7th Avenue. Smack in Times Square.
As we approached the intersection where her hotel was we were shocked to see barricades and a contained throng of people. The street was empty, a startling apparition in NYC and two policemen were telling us we weren't going anywhere for a long time. It was 7:40 PM.
Funny thing was my husband and I had walked up and down the streets for the last twenty minutes trying to track down the Grace Hotel since we didn't have a street address. I wouldn't be surprised if Shahzad passed right by us making his get-away.
While behind the barricade, I turned to ask a fellow by-stander what was happening. She didn't seem to know either. Turning back to my husband, he was gone. I remember last seeing him a few feet away on his phone. But moments later he came striding up with his colleague in tow. She and her son had been evaculated from their hotel as had all the hotel guests in the area. Hmmm...this was serious. You probably know by now that people emptied out of restaurants and Broadway theatres. The streets were a veritable ghost town.
We walked two streets east and had dinner and then walked our dinner guests back to their street sure that by 10:20 PM they could resume their fight with jet lag on their hotel bed. But not so, the streets were still closed. We heard the next morning that our dinner companions were let into their hotel at 11:40 PM. We also heard about a car full of explosives just where we had been, and that thankfully Shahzad's bomb-making and setting skills are still in need of work.
Had they not been, that might have been the end of me, my husband and our guests and of course thousands of others milling around Times Square on a beautiful Saturday evening.
Had I walked through the World Trade Center just as I did on September 10, 2001 at 9:15 AM but one day later, I also would probably not be here.
I live in New York City. Like my fellow New Yorkers, I'm not going anywhere and I'm not going to change how I live and move around here. While I will say something if I see something, I will not live with fear or with one eye looking over my shoulder. I live with diabetes just the same way.