Not in any particular order.
1. Diabetes is caused by poor diet and fitness. No, Diabetes is not caused by sugar. There are a few different reasons why a person can develop diabetes, and while bad eating habits and being sedentary make some of it worse, it does not cause it to happen. Type 1 is caused when the pancreas stops producing insulin. Type 2 is a genetic disease caused by a combination of insulin resistance, low pancreatic activity, and faulty liver function, not always all three, in any combination of the above. Type 1.5 is autoimmune and is, to keep it short, slow onset Type 1. Gestational Diabetes is diabetes that develops during a pregnancy. And traumatic injury or disease to the pancreas can cause diabetes. But Twinkies and Coke do not cause it.
2. Diabetes can be cured. This one is my pet peeve so let me be completely clear.
THERE IS NO CURE FOR DIABETES
No matter what kind you have, at this point in time there is no cure. Some, I repeat SOME Type 2's can go into a remission like state where, through a combination of lifestyle changes and the good fortune of their diabetes being less severe than others, their blood glucose numbers are in a normal range. This is not the same thing as being cured. You can't cure genes.
3. Type 1 or 2 Diabetes is worse than the other type. No. Disease doesn't work that way. There is no better or worse kind of diabetes. It all sucks. Having a disease that affects how you need to life your life, affects every organ in your body, affects the length of your life, and much more, is not a pissing contest. None of this is a competition. That's like saying one form of cancer is better or worse than another.
4. Type 1 is something children get. Incorrect. Type 1 Diabetes, an autoimmune disease that happens when the immune system attacks the beta cells of the pancreas and kills off most or all insulin production in the body, can happen to any person at any age. Nobody knows why it happens, nobody can stop it, and it's not predictable.
5. Type 2 is something old people get. Incorrect. Type 2 Diabetes, a genetic disease, happens when the body becomes resistant to it's own insulin, the liver dumps glucose into the blood stream incorrectly, and the pancreas may or may not make insulin in the proper amounts. It can happen to anybody with the gene, at any age, nobody can stop it, and it's not predictable.
6. Diabetes isn't that bad, you just have to eat right. Wrong. Diabetes causes more deaths per year than breast cancer and AIDS combined. There are complications from diabetes, such as heart disease and stroke, that are deadly.
7. Diabetics can't eat sugar, or can't eat carbs. That is absolutely not true. The human body requires carbohydrates. Not eating carbs will cause as much damage and problems to a diabetic as eating too much. Telling a diabetic that they shouldn't eat that is just an asshole kind of thing to say, unless you're talking to your child who you're trying to teach. A diabetic needs to count how many carbs they're consuming and balance it out with the right amount of insulin or medication. They got this; back off.
8. Diabetics get sick more easily. No, we really don't. However, when we do get sick, the immune response in our bodies makes our blood glucose numbers jump around like kangaroos and more difficult to control. So sometimes when we get sick, it's kind of a big deal.
9. Fruit is healthy and natural so a diabetic can eat it. Bonk! SO not true! Fruit is sweet, and full of carbohydrates, and needs to be properly accounted for when we count those carbs.
10. There are lots of products that can cure diabetes. OMG I hate those things and the people who push them. I'll reiterate that diabetes does not have a cure. Taking some product you read about online, saw in a commercial, had pretty packaging on the store shelf, or somebody tried to sell you, not only won't cure diabetes but may cause it's own set of problems. Just because something is organic and made of all natural products doesn't mean there aren't side effects, it doesn't mean it's good for you, and it sure as shit doesn't mean it's going to cure you of an incurable disease. If you want to try something do this -- print up a list of all it's ingredients and take that to your pharmacist. Talk to the pharmacist about what medications you're currently taking and if any of the ingredients listed will interfere with them. If you get a green light, go ahead and throw your money at it. It's your body. But don't say nobody warned you.
11. Diabetics need insulin. To be perfectly precise, every person needs insulin to live. Some people don't make enough on their own and need to outsource production, is all. But a diagnosis of diabetes doesn't mean that you will automatically go on insulin. Many Type 2 diabetics control just fine with oral medication combined with diet and fitness.
12. Diabetes only affects rich countries. Not correct. Diabetes occurs in every demographic, in every country, on every continent, in every color, in every religion, in every income bracket, in every age. It doesn't discriminate.
13. Diabetes care isn't costly. Oh, how I wish! Some diabetes medications that have been around a while are somewhat affordable, but no, diabetes is incredibly expensive. Between the doctor visits every three months, the blood tests they perform, the self testing multiple times a day, the medications, the complications.....no, none of it is inexpensive.
14. Diabetics use their diabetes as an excuse to get out of things. Well, I can't say that 100% of diabetics would never, ever do such a thing, but it's pretty likely that it's not true and you're just not understanding what's happening. A diabetic needs to test their blood glucose regularly, they need to eat regularly, they need to take their medications regularly, and if their blood glucose levels get too high or low they need to treat that immediately. So if they need to take a break from class or from their job or from whatever it is that they're doing to make sure things are okay, then they really do need to do that. Would you rather they just passed out in front of you to prove they weren't making it up?
Oh, there are a lot of things that people don't know about diabetes. Heck, there are a lot of diabetics who don't understand it themselves and have misconceptions! There've been studies! But you know, if you have questions please feel free to ask them. Oh, and here's a study on how even many diabetics are lacking in education and understanding of what's happening to their own bodies.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660470/
Tuesday, December 23, 2014
So What Is Diabetes?
I will start by saying that I am a diabetic. I was diagnosed with gestational diabetes in 2000 when I was pregnant with my son, at age 26. At 30 years old I was officially diagnosed with Type 2 Diabetes. I started out on oral medications combined with diet and exercise but eventually went to insulin. I am now on an insulin pump. I have joined a diabetes group on Facebook and was really stunned by reports of the misconceptions and lack of understanding by families and friends of diabetics everywhere. I totally get that when something doesn't affect you personally, or somebody that you love, that you don't study up on it. When it's somebody you know, though, don't you usually learn a bit more about it? So I started a Facebook post this morning asking a few basic questions about diabetes from all the folks on my friends list. The post hasn't been up there very long and already there are some of the stereotypical misconceptions up there as answers. So in this blog post I'm going to explain what diabetes is, what some of the different types are, and how they're generally treated.
To begin, diabetes in general describes an inability of the person's body to correctly produce and/or use the hormone insulin. Insulin is a hormone produced by beta cells that are on your pancreas. Your body uses insulin to move glucose (sugar) from food from the bloodstream into cells throughout the body where it is then used for energy.
Type 1 Diabetes, often called Juvenile Diabetes, is an Autoimmune Disease. What this means is that at some point, the body decided that those beta cells I mentioned weren't supposed to be there and the immune system attacks and kills off some or all of them. This can happen at varying speeds. Nobody knows why this happens. This can happen at ANY age. You can develop Type 1 Diabetes at 2, at 12, at 22, 52, etc.....it is not solely something that happens to children. With those beta cells gone, the body does not produce any insulin on its own and so the person MUST give themselves insulin in order to survive. No diet, no exercise, no pills will help.
Type 2 Diabetes used to be referred to as Adult Onset Diabetes. In my grandmother's generation it often didn't present itself until a person reached retirement age. Today we are seeing it in people of all ages, including children. Type 2 Diabetes is a Genetic Disease. A person can be in excellent health and eat a perfect diet and develop Type 2 Diabetes. A person can eat nothing but Twinkies and Chips, drink four liters of soda a day, never exercise, and be obese and still not develop Type 2 Diabetes; it's about genetics. The disease can present with no causal factors, it can just pop up at any time. However, it can also be brought out earlier through a lack of activity or by poor diet. It is not caused by diet or lack of activity, those are only factors that can cause it to present earlier than it MIGHT otherwise have developed. With Type 2 Diabetes a person's body becomes resistant to the insulin it produces, as well as possible changes in the amount of insulin production. Additionally, the liver, which produces it's own glucose (a survival mechanism meant to save a person who is starving) decides for unknown reasons to dump it's glucose into the blood stream when it doesn't really need to. Type 2 Diabetes has a lot of varying ways it can be treated. For about 13% of Type 2s it can be controlled through diet and exercise. The largest percentage of Type 2s control their Blood Glucose numbers with oral medications combined with diet and exercise. It is also controlled with insulin sometimes combined with the oral medications, sometimes not. Type 2 Diabetes is a progressive disease. A person can be perfectly controlled with only diet and exercise and still have to go on insulin at some point as their diabetes becomes progressively worse.
For some people, diabetes is developed due to traumatic injury to their pancreas, or due to other health conditions, all of which are beyond their control. Their treatment depends on how much, if any, insulin their bodies can produce.
Gestational Diabetes develops during a pregnancy and must be strictly controlled for the safety of the unborn baby. It often does not last beyond the pregnancy, if it's been properly controlled. However, having gestational diabetes is an indicator that Type 2 Diabetes could develop at some point.
LADA (Latent Autoimmune Diabetes in Adults) or Type 1.5 diabetes is a type of diabetes that often presents as Type 2 Diabetes and is very often misdiagnosed as such. It is an autoimmune disorder where the beta cells of the pancreas are being attacked by the immune system but at a slower rate and therefore mimicking Type 2 at early stages. When the attack on the beta cells progresses and insulin production ceases it presents more as Type 1. There is a test that can be administered to determine if a person has Type 2 or Type 1.5 if the person and their doctor feel it's called for.
So! Those are the different categories of Diabetes, how they are developed, how they are generally treated.
A diabetic does not need to avoid eating sugar. It's not even "sugar" that a diabetic is watching anyway, it's all carbohydrates. Even so, a diabetic does not need to avoid carbs and SHOULD NOT avoid them. Carbs are a main source of fuel for our bodies and not eating them at all will actually cause a diabetic's blood glucose numbers to rise, not fall, due to that pesky thing I mentioned earlier about the liver. It's called a Liver Dump, and if you eat zero carbs your liver will dump glucose into your blood to save you. This raises blood glucose numbers. So avoiding all carbs accomplishes nothing and makes it all worse.
There are two types of diabetic emergencies: Blood Glucose going too low, and BG going too high.
When a person's blood glucose drops too low, also called Insulin Shock, it is a life threatening emergency and needs to be treated immediately. The signs that this is happening are similar to being drunk and often mistaken for that. Lightheaded, confusion, slurred speech, dizzy, nausea, hot flashes, cold sweats, loss of motor control, among others, and if not treated, loss of consciousness. To treat insulin shock, if the person is still awake, give them regular soda to drink, orange juice is an old stand-by, frosting is excellent. Many diabetics carry Glucose Tablets or Gel with them to administer when this happens. Some also have a kit with an injection to help if they lose consciousness. If a person is not conscious, if you have frosting, smear some along their gums but be cautious not to block the airway. Call 911 for assistance.
When a person's blood glucose rises beyond levels that their body is accustomed to, this is also very dangerous and can lead to a Diabetic Coma. The person often becomes lethargic and sleepy and may lose consciousness. There is nothing you can do to help them other than to call 911, as they need medical attention.
If you do not know which is the problem, too low or too high, you treat as if it's too low. If they're too low and you treat it you may save their life. If they're too high and you treat it as a low you will not be significantly changing anything.
To begin, diabetes in general describes an inability of the person's body to correctly produce and/or use the hormone insulin. Insulin is a hormone produced by beta cells that are on your pancreas. Your body uses insulin to move glucose (sugar) from food from the bloodstream into cells throughout the body where it is then used for energy.
Type 1 Diabetes, often called Juvenile Diabetes, is an Autoimmune Disease. What this means is that at some point, the body decided that those beta cells I mentioned weren't supposed to be there and the immune system attacks and kills off some or all of them. This can happen at varying speeds. Nobody knows why this happens. This can happen at ANY age. You can develop Type 1 Diabetes at 2, at 12, at 22, 52, etc.....it is not solely something that happens to children. With those beta cells gone, the body does not produce any insulin on its own and so the person MUST give themselves insulin in order to survive. No diet, no exercise, no pills will help.
Type 2 Diabetes used to be referred to as Adult Onset Diabetes. In my grandmother's generation it often didn't present itself until a person reached retirement age. Today we are seeing it in people of all ages, including children. Type 2 Diabetes is a Genetic Disease. A person can be in excellent health and eat a perfect diet and develop Type 2 Diabetes. A person can eat nothing but Twinkies and Chips, drink four liters of soda a day, never exercise, and be obese and still not develop Type 2 Diabetes; it's about genetics. The disease can present with no causal factors, it can just pop up at any time. However, it can also be brought out earlier through a lack of activity or by poor diet. It is not caused by diet or lack of activity, those are only factors that can cause it to present earlier than it MIGHT otherwise have developed. With Type 2 Diabetes a person's body becomes resistant to the insulin it produces, as well as possible changes in the amount of insulin production. Additionally, the liver, which produces it's own glucose (a survival mechanism meant to save a person who is starving) decides for unknown reasons to dump it's glucose into the blood stream when it doesn't really need to. Type 2 Diabetes has a lot of varying ways it can be treated. For about 13% of Type 2s it can be controlled through diet and exercise. The largest percentage of Type 2s control their Blood Glucose numbers with oral medications combined with diet and exercise. It is also controlled with insulin sometimes combined with the oral medications, sometimes not. Type 2 Diabetes is a progressive disease. A person can be perfectly controlled with only diet and exercise and still have to go on insulin at some point as their diabetes becomes progressively worse.
For some people, diabetes is developed due to traumatic injury to their pancreas, or due to other health conditions, all of which are beyond their control. Their treatment depends on how much, if any, insulin their bodies can produce.
Gestational Diabetes develops during a pregnancy and must be strictly controlled for the safety of the unborn baby. It often does not last beyond the pregnancy, if it's been properly controlled. However, having gestational diabetes is an indicator that Type 2 Diabetes could develop at some point.
LADA (Latent Autoimmune Diabetes in Adults) or Type 1.5 diabetes is a type of diabetes that often presents as Type 2 Diabetes and is very often misdiagnosed as such. It is an autoimmune disorder where the beta cells of the pancreas are being attacked by the immune system but at a slower rate and therefore mimicking Type 2 at early stages. When the attack on the beta cells progresses and insulin production ceases it presents more as Type 1. There is a test that can be administered to determine if a person has Type 2 or Type 1.5 if the person and their doctor feel it's called for.
So! Those are the different categories of Diabetes, how they are developed, how they are generally treated.
A diabetic does not need to avoid eating sugar. It's not even "sugar" that a diabetic is watching anyway, it's all carbohydrates. Even so, a diabetic does not need to avoid carbs and SHOULD NOT avoid them. Carbs are a main source of fuel for our bodies and not eating them at all will actually cause a diabetic's blood glucose numbers to rise, not fall, due to that pesky thing I mentioned earlier about the liver. It's called a Liver Dump, and if you eat zero carbs your liver will dump glucose into your blood to save you. This raises blood glucose numbers. So avoiding all carbs accomplishes nothing and makes it all worse.
There are two types of diabetic emergencies: Blood Glucose going too low, and BG going too high.
When a person's blood glucose drops too low, also called Insulin Shock, it is a life threatening emergency and needs to be treated immediately. The signs that this is happening are similar to being drunk and often mistaken for that. Lightheaded, confusion, slurred speech, dizzy, nausea, hot flashes, cold sweats, loss of motor control, among others, and if not treated, loss of consciousness. To treat insulin shock, if the person is still awake, give them regular soda to drink, orange juice is an old stand-by, frosting is excellent. Many diabetics carry Glucose Tablets or Gel with them to administer when this happens. Some also have a kit with an injection to help if they lose consciousness. If a person is not conscious, if you have frosting, smear some along their gums but be cautious not to block the airway. Call 911 for assistance.
When a person's blood glucose rises beyond levels that their body is accustomed to, this is also very dangerous and can lead to a Diabetic Coma. The person often becomes lethargic and sleepy and may lose consciousness. There is nothing you can do to help them other than to call 911, as they need medical attention.
If you do not know which is the problem, too low or too high, you treat as if it's too low. If they're too low and you treat it you may save their life. If they're too high and you treat it as a low you will not be significantly changing anything.
ETA: emergency treatment is not something that should be administered without knowing the situation as it could make things worse. Your best move is to call 911 and do as you're told by the dispatcher. If you are a diabetic it's a smart plan to let the people around you know what to do if you feel off, or to make sure people you are often with know what to do for you in emergency situations. Wearing a Medic Alert bracelet is a smart move, too.
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So those memes and jokes like: Andrew had 10 candy bars and ate 8 of them, what does Andrew have? Andrew has diabetes! Those jokes may be amusing, but they are wrong and they do spread inaccuracies and misconceptions about diabetes. (I usually find them funny, but many diabetics are not so amused.)
And telling your diabetic cousin that maybe he shouldn't have any pie after Christmas dinner? Not cool. Unless you understand his diabetes, know what his blood glucose numbers are, know how he's medicated, and know what he should or shouldn't be eating, because he told you, then please keep your thoughts to yourself. You may be correct or you may be unaware and insulting.
-------------------------------------------------------------------------
So those memes and jokes like: Andrew had 10 candy bars and ate 8 of them, what does Andrew have? Andrew has diabetes! Those jokes may be amusing, but they are wrong and they do spread inaccuracies and misconceptions about diabetes. (I usually find them funny, but many diabetics are not so amused.)
And telling your diabetic cousin that maybe he shouldn't have any pie after Christmas dinner? Not cool. Unless you understand his diabetes, know what his blood glucose numbers are, know how he's medicated, and know what he should or shouldn't be eating, because he told you, then please keep your thoughts to yourself. You may be correct or you may be unaware and insulting.
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