An argument for kindness in the diabetes world

WRITTEN BY: Lauren Salko

This is one part of a two-part series on allyship in the diabetes community. Read Bill Santos’s piece for Beyond Type 2 reflecting on finding common ground in the diabetes community.

This is what I used to tell people when asked the difference between Type 1 diabetes and Type 2 diabetes: “Type 1 diabetes is an autoimmune disease and Type 2 diabetes is caused by poor diet and lifestyle choices”.

I still cringe when I think about how inconsiderate and sophomoric my comments were. Honestly, I was afraid of the stigma attached to Type 2 diabetes and I wanted to make sure that people knew that my diabetes was not my “fault”.

Now, the way many people with Type 1 talk about those with Type 2 makes me absolutely livid. The worst part is this seems to be a growing trend in the T1D community. Growing up, my mom always told me that dimming someone else’s light would never make mine shine brighter.

I compete as an individual in professional skiing. This lesson is something that I strive to implement every day. The performance of others never has and will never have any bearing on my own success. When my teammates or friends grow and succeed, so do I. I do not need others to fail to reach my goals.

I understand that Type 1 diabetes and Type 2 diabetes are different diseases, and I’m aware that there are differences between the two. But hear me loud and clear: there is absolutely no reason for the Type 1 community to put down those living with Type 2 or to devalue their experiences as people with diabetes. I know this comes from fearing the blame people often place on those living with T2D being placed on you or your child. No matter how inaccurate it is, it still hurts when people pass judgment.

Here’s the thing: when you make negative statements about Type 2 diabetes and its causes, you aren’t helping yourself. You’re just hurting others. Dimming someone else’s light doesn’t make yours shine any brighter.

Did you know that Type 2 diabetes has a stronger link to family history and lineage than Type 1? Did you know that insulin resistance causes weight gain, which can cause even more insulin resistance? What a vicious cycle.

We also need to recognize that a lot of the advances in technology and diabetes treatments we have come to rely on are available now because of the Type 2 community. Only 5% of people with diabetes have T1D, so the Type 2 diabetes community has a lot to do with the incentives and direction driving diabetes innovation.

The next time someone asks you about the difference between Type 1 and Type 2 diabetes, I hope you take the opportunity to educate! Don’t just take the easy way out and make negative (and often times incorrect) comments about Type 2 diabetes. Be the biggest ally you can for EVERYONE living with diabetes by standing up for all of us in the face of ignorance.

Diabetes is rough, no matter what kind you have, so have some compassion for your brothers and sisters who also deal with high and low blood sugars, counting carbs, taking medication, insurance fights, and fearing complications. Kindness will get us further than stigma and othering ever will.

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applause

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I agree!

Thank you for posting this. I’m a T2 who was diagnosed when I was quite thin, and even losing more weight, exercising and watching my diet did not control it. I’ve been on insulin now for 35 years and on a pump for 18 years.

My best friend just got diagnosed last year…she’s always been painfully thin, and still has T2.

In both our cases, we have a strong family history of T2.

Interestingly, though, it seems that more elderly people blame their peers for having diabetes, rather than blaming “young” people whom they seem to assume “didn’t cause it themselves.”

The other phrasing that annoys me no end is: “oh, you’re on a pump. You must have the bad kind of diabetes.” Like there’s any good kind, lol.

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Totally agree @Ruth4.

Your body doesn’t care which variety of diabetes you have, All require managing BG’s, dealing with highs and lows, and ultimately, the risk of significant diabetic complications later in life.

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@Ruth4 I just read a research study that of Type 2’s “Only 6% of patients (n = 15) had an insufficient beta cell reserve.” I have to wonder if you ever had the tests for type 1? Needing insulin early is a sign of type 1. It is guessed about 10% of type 2’s are not overweight.

Since 40% of type 1’s are misdiagnosed as type 2’s at first, sometimes for long lengths of time like I was, I like to make sure everyone is made aware, just in case.

I don’t know if the antibody tests were done when I was diagnosed in 1984. I had them done myself when I went on medicare, and they were negative. My C-peptide test does qualify me for a pump, but I’m still categorized as a T2, which means I don’t qualify for a CGM on medicare. But since I don’t really want or need a CGM anyway, it’s not a problem.

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My husband’s last A1c was 6. He is quite thin and no one in his family had diabetes. His A1c’s started rising when he started taking statins several years ago.

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Hi Ruth:

This statement is not true. You may not qualify for a CGM on Medicare for another reason but being T2 is certainly not one of them. Here are the Medicare requirements for a Dexcom CGM:

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Yes, we all need more kindness, and this “argument” is very powerful. I will disagree with one statement–Type 1 is not 5% of all diabetes. A huge number of people with Type 1 diabetes are misdiagnosed as having Type 2 diabetes, simply because they are adults. In fact, study after study (with the first published in 1977) show that ~10% of people diagnosed with “Type 2” diabetes are autoantibody positive, have Type 1 diabetes, and have been misdiagnosed. So Type 1 is way more than 5%!

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@CJ114 I wonder if that’s a recent change. I know they didn’t cover cgm’s for T2’s for a while.

Anyway, as it happens, I really don’t want a CGM. My A1c’s for the past year have been steady at 5.8, with not many lows and none below the 50’s. I did have one A1c at 5.6, but I was having a lot of serious lows, so I tweaked my basal rate a bit and that took care of it. For the past three months, the most serious low I’ve had has been 58 to somewhere in the 60’s, and not more than maybe once or twice a week. I can live with that.

I’ve also got an adhesive allergy, so I have to use barrier tape which is a pain getting medicare to pay for. I definitely do not want another site to stick on my body, lol.

But I am glad to hear the Medicare now does cover cgm’s for T2’s…so stupid for them not to, right?

This mindset was very prevalent back in the early 70’s. My parents attending parent support groups had many parents say things like this to offset those discussions people would have about ways to cure their kids. But wow, it turned ugly.
Over the years, talking with many fellow PWD both 1 & 2, I believe that type 2 is so much harder. Most everyone I talk with has multiple problems. Every organ system is in the mix, which leads to the many different drugs and treatment plans. I just don’t think handling all that is easy, along with the blame and shame everyone, medical professionals also, heap on people with type 2. Who can do all that, plus lose weight when everything is stacked against you. No one can control their family history. There is nothing you can do about that. If the genes are there, they are there. Even if a person loses the weight, that doesn’t mean they won’t get diabetes. Type 2 is such a complicated disease. There is no easy fix.
And while we all want a cure, I think type 1 will be cured long before type 2. There is just way too much going on with type 2.
So I think all of us being helpful and supportive is the way to go. It’s the way everyone should be with everyone. Just think how much nicer the world could be. And in regards to diabetes, just think of the numbers. We are a bigger force to deal with.

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Yes, it was not until early to Mid 2017 that that Medicare started covering CGM for T2 patients, at which time I got on the Dexcom G5 and it has given me the necessary data to remain in the same ranges as a non-diabetic. The system is not perfect, but still totally awesome for anyone that wants to put the effort into learning how to use it properly.

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