26 April 2012

Diabetes: ignorance is certainly not bliss

I'm sure that many of you will have seen the delightfully sensationalist headlines in the Papers today: "Diabetes will Bankrupt the NHS" and others to that effect. I first stumbled across the story whilst on the BBC News website during my Economics class this morning, and naturally felt compelled to read on following this (rather dramatic) statement.

I understand that there is no denying the figures in terms of cost. Furthermore, I am not for one moment saying that the amount being spent is good; neither for the country in terms of trying to curb spending, and that it reflects the extent of diabetes-related complications. However, what infuriated me was that, just beneath the headline, there was a picture of a person standing on scales (see picture below); moreover, visit The Guardian and just beneath their headline: "Diabetes threatens to bankrupt NHS", you will see a picture of a clearly obese person - the two together practically scream at readers "look at these fat people wasting all our money", not something I have to say I would have expected from a newspaper that I have always respected, and thought steered away from 'tabloid-style' sensationalism.

Diabetes assessment  BBC News Picture
One thing it  does, is immediately isolates not only type 1 diabetics but also many type 2s. I have never and will never be one of those Type 1s who sits on their golden throne and looks down on Type 2s, something I have seen before in forums, comments on newspapers etc... Just as it is completely wrong to believe that certain cancers are always linked to smoking, many type 2s did leave a healthy lifestyle prior to diagnosis. In the case of  nearly all Type 1 diabetics, nevertheless, that 'obesity' picture is both insensitive and so destructive in trying to educate people about the condition. I distinctly remember when we studied Diabetes in Biology for my GCSE course. The distinction between Type 1 and Type 2 was very unclear, and I remember always telling my friend next to me to write "Type 2 Diabetes", as one of the potential consequences of obesity/bad diet. Type 1 is an auto-immune disease, and I always get a sickening feeling in my stomach whenever I read an argument/ hear someone talk about diabetes and imply that it is somehow 'your fault'. Just because 90% of diabetes is Type 2, there are still around 300,000 people in the UK who fall into the 'other category' (Type 1).  I was diagnosed when I was 7 (Juvenile Diabetes) and cannot really remember my life without the condition (condition, not disease). One of my vivid recollections in that first Biology lesson was people turning to look at me when 'obesity' was mentioned, some with looks of confusion on their faces, as if they expected to see some gigantic whale sitting where I should be!

It is very easy to picture diabetics sitting eating burgers and 'denying' the problem - and don't get me wrong, there are many who do continue their lives and ignore the realities. On the other hand, I do not feel it is fair for anyone to pass judgement on those who do struggle with either Type 1 or Type 2, if they have never had the condition themselves. I am certainly no saint, and am presently struggling with low blood sugars and have been warned about the potential 'long-term' impact. But then the same could be said if I was having lots of highs. For many Type 1s (including me) it is a fruitless task to try and maintain control. My diabetes is like a crazy yo-yo that never seems to tire from swinging me back-and-forth. It can be so draining, and many times I do just feel like giving up.

The 'costs' in the articles today referred to complications, yet The Independent article did not even mention the Type 1/ Type 2 breakdown, of which significantly more is spent on Type 2. Additionally, The Guardian only added the statistics in the final paragraph, and only after complaints from on-line readers; the end of the article read: "amended on 25 April 2012 to clarify the different causes and costs relating to Type 1 and Type 2 diabetes." It should have been the first thing written! Otherwise people will have made snap-judgements on the 'wasteful' money. I just found out last week that once I leave the Children's Clinic (this summer) I will no longer receive any funding for the Continuous Glucose Monitoring, and although not essential for me it is frustrating to read about how too much money is being 'wasted', and still I will not have this.  I believe the root of the problem lies largely with the misguided advice of Diet 'experts' etc.. in the last 25 years or so. Whilst they have advocated a 'low-fat; high-carb' diet, they clearly haven't taken into account that this is possibly the worst thing for BG control. Low GI foods cause BG levels to rise so quickly, often why it is better for Type 1s to inject insulin a bit prior to eating foods like Pasta etc... and Type 2s to be more weary about the volume they consume of these types of food. If the 'proffesionals' would focus on changing their tune, and advocating the 'lower GI carb' route, this could see huge steps being taken to help reduce the number of new Type 2 cases. Some of the money could then be invested in other areas of treatment, possibly for Type 1s such as CGM or increasing funding for insulin pumps for; this is still quite low, yet it improves control so much so could help reduce costs that derive from later complications.

The main sense of frustration I took away today was the destructive impact it will have on society's already tainted perception of diabetes. There needs to be a clearer differentiation between the two Types, because apart from the common link of blood sugar levels, both treatment, and often causes, are completely different. Furthermore, the old 'obesity' image that goes with every article on diabetes is just pure ignorance, plain and simple, and I would have expected so much better from the websites that I visited to read their articles on this story, including the BBC. A comment on one of the articles even proposed gastric-bands as 'diabetic surgery', as it makes people 'eat less' - this just demonstrates the hugely inaccurate cultural view of diabetes as a whole, and is something which needs to change.
At the end of the day, I did not play any part in having this condition; it was just the hand I was dealt with and I have tried my hardest over the last ten years to accept that: this is what it is, I can't change it, so I have to make the most of it. However, considering this I hope people will be able to understand the frustration that I share with many others, on being imagined as this 'lazy, overweight, money-wasting' teenager - I'm a size 8 for goodness sake and my favourite food is strawberries! Through no fault of my own, I have a tube inside me 24/7, most likely for the rest of my life, and BG test about 8-10 times a day, not to mention the emotional roller-coaster that is having to live with the constant highs and lows. And although I am not stereotyping Type 2s in any way, shape or form, there are some cases that do stem from diet/lifestyle/obesity - to be grouped with this in one 'generalisation' is therefore quite upsetting.
In my lifetime I really hope to raise awareness of diabetes; I've started already with my peers to try and change some 'diabetes stereotypes', including the: "will you die without insulin?" and "will you have diabetes for life?", some pretty basic things but I'm getting there! And although it is very tempting to feel extremely irritated with them, in reality it is not their fault - there is just so little education. In the US I feel there is a greater sense of understanding, as the condition is so much more common, not just type 2 but type 1. I really hope that in the future this spreads to the UK, and that these stereotypes are removed. The first step, however, is with the media who display such a lack of knowledge and consequently worsen the situation. Diabetes UK are big supporters of improving this, which is why it is so important to show support.

And finally, just to prove my point about the 'stereotype'...

Type 2 diabetes
The photo at the top of the Article by The Guardian


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