This can apply to T1’s too as far as mindset but I have to say in my years of public service, those with T2s seem to be more varied in how they think or handle about their condition. For me, at first was denial. I knew that could not visit denial long without irreversible damage. I had to own it, manage it and live with it the best I could. A family member, I cannot explain his attitude, Father of 3 has had a death defying heart attack, eats a nonspecific diet and does not appear to make efforts to manage his condition. A geriatric family friend had T2, skin cancer, prostate cancer Coranary Artery Disease. He quit smoking in his 60’s, which was a big victory. Any diet modification was not so apparent.he nearly died from triple bypass surgery and when they talked of Bypass surgery again, this big man cried and said he would exercise and change his diet. My heart ached for his pain. I knew this vow came too late as the damage was done. Sometimes certain approaches are due to mindset, sometimes lack of education. Educate we can do but what about mindset or attitude? That seems to be the hard part.
I wonder about this as well. I think one of the “advantages” of T1 is that, because it is an extremely acute condition right from its onset, you sort of don’t really have any choice about denial. I mean obviously people vary in their degree of self care over time, but we all get kicked in the posterior pretty hard right at the start: you can have the injections or you can have the DKA coma, which do you choose? Whereas T2 as a general thing seems to start out much more slowly and ambiguously and how acute it is varies all over the map; as a consequence it’s easier to start out kind of minimizing it. One of my best pals was told his BGs were flirting with the T2 borderline about ten years ago. We recently got together for a recording session after a long absence and this came up. I was showing off my Dexcom and asked him if he tested his BGs at all. “Well, basically no. I just take the Metformin pill in the a.m. and forget about it.” I didn’t go any farther into it with him but it did bring home the difference to me. He’s doing fine, so far, and I gather he sees a Dr regularly and his A1Cs are acceptable, so he (not unreasonably) pushes it out to the margins of stuff he’s concerned about, whereas for me it is pretty much a minute-by-minute awareness, concern occasionally shading over into panic, for 31 years.
One other thing this topic brings to mind: For various reasons it only recently occurred to me that my experience of one of the commonest physiological sensations differs profoundly from that of the non-T1 population. Namely: being hungry. I’m not sure this would be as true if I hadn’t spent the first 20 years after dx on R/NPH, or as I fondly refer to it, the “Eat Now or DIE!” regime. But whereas for a “normal” person it just means “time for a trip to the fridge,” or “holy crap that meeting ran right through my lunch hour!” for me, my brain has had physiologically induced into it the association hunger=danger. It is NOT OK to be hungry. For me “hungry” is a sensation that always comes haloed in danger-red glow that at any moment can slide over to warning klaxons and alarm bells. Of course everyone knows what it’s like to skip a meal or something and feel the version of this that results in phrases like “I’m starving!” “I could eat a horse” and the like, but that only makes it more difficult to explain to non-insulin-dependents what a different thing this is. Even my friends who experience some form of preprandial hypoglycemia have no idea of that verging-on-panic awareness that the trap door is opening and you have an artifically-induced load of insulin on board that is shoving you right toward it and the rate is going to accelerate unless you do something about it RIGHT. NOW. My wife has gotten to be a pretty good interpreter of it, but even she doesn’t always understand that when I say “I need to eat something now” what I mean is "I need to EAT something NOWWWWWW!!!
The particular aspect of this that I’m confronting recently arises from changing my routine to start bike-commuting, combined with getting a CGM and trying to turn all that into some weight loss by also altering my diet. You know how they say “you should always leave the table a little hungry,” but for me that butts right up against a lifetime of virtually pavlovian conditioning that hunger=danger. It’s not that I can’t overcome it or anything, but it definitely messes with me at times. I’d be curious whether other insulin-dependents experience some version of this.
Yes, I agree with you in regards to the developments of the condition influencing attitudes. One thing that causes me to scratch my head is the medical profession’s are target on the A1C vs. daily values. A drastic high or low can send us to the ER but the A1C can be good. I think there is something wrong with that. Maybe later it will be revealed that approach may not be the best.
Yes, I feel starved too high or too low. Not being hungry to me means I am ok. Odd how different people get different signals.
Because I watched my brother & mother suffer all kinds of diabetic complications, largely due to noncompliant behavior, when i was diagnosed T2, my main goal was not to go down their path. I learned, I adjusted, I monitored my diet & exercise, I joined communities like TuD. I learned to take control of life with diabetes.Five years–knock wood-- I’ve suffered no complications.
My brother, at the same time, has continued to make poor choices.I’m saddened indeed to watch his health decline. His emotional issues with food are much deeper than mine. While I have made gentle suggestions to encourage better diet & fitness options, he has generally brushed me off. His life, his choices, I guess.
I feel for you Deborah3. I don’t understand the rebellious attitude vs. the take charge attitude. The lack of care for ones self hurts all that care. We can only govern ourselves and our own care. I do see the same behavior in our family and as a healthcare provider I witness such behavior. I wished there was some medicine that would change those behaviors.
Are people like my brother “rebellious” or passive? Maybe this kind of behavior is passive-aggressive.
As for a medicine that might help, he has been in counseling for a few years, but dealing with other issues.
My advice to some one with a partner/family member who flaunts his diabetes care would be to get the PWD to “Living With Diabetes” class, support group, and/or counseling. And maybe offer to attend together.
@Deborah3: whatever it is, my brother is pretty much the same way. Worse, he’s not active physically and views having a doctor appointment as being “very busy”. He doesn’t own a cell phone or a computer. He’s much older, almost 20 yrs my senior. His father was killed in the WWll and after the war my mom re-married and had me. So him and I are actually half-siblings.
I was diagnosed with T2D about a year ago although my (then) PCP had been telling me that my BG was high about 8 years prior. If it was, no one ever told me. So now, bingo, I know. Was in shock and denial at the delivery of the breaking news, am at an acceptance now. I am seeing lots of attitude online and offline, about type 2 diabetics eating themselves to it, therefore it’s our own fault. Some folks just HAVE to blame someone; whatever rocks their boat. Type 2 is genetic, it’s nature vs nurture when nature wins.
About a week ago I have started exercising, doing brisk walks a few times a day, and am seeing a drastic improvement in my BG levels. This morning, after doing my constitutional walk for about 15 min, my fasting number is 94. Yay! It works!
@1DebY: more medicine is that right? Like we don’t take enough of them already. Being a healthcare provider, you’re aware that every medicine has side effects, I’m pretty sure. Such as flu vaccine causing damage to the peripheral nervous system known as Gullain-Barre; but I digress.
I would say some sort of a counseling might do better than more pills. Some people like my brother, might benefit from seeing a PT or OT, as he seems so helpless with doing just about anything, and needs help constantly. I’m so glad I’m miles away because I just don’t get it. The way I see it, he is physically capable but probably not so mentally. The problem is, his wife used to be in charge of everything. It was this way up until she went down with Alzheimers. Now he has to be in charge of everything, and he just won’t.
Some things aren’t clear cut, are they now?
Anna–
Your feelings of shock mirrored mine in first year of diagnosis. Wonderful that you’re exercising & seeing the good results. I wrote a few blogs you might like on A Sweet Life (ie http://asweetlife.org/feature/arugula-and-me-a-first-year-with-diabetes/). Be well!
@Deborah3: thanks, will do (read your blog). In the meantime, you might want to read mine: Brisk Walks, My Daily Constitutional |
@Deborah3: I hear you. You did everything right, yet are having T2D. The problem is, T2D is genetic. You had it in your family which explains. Too bad that media tends to mislead us, telling us that you can either prevent or cure T2D by watching your diet and exercising. Yet T2D happens to thin people or to the athletes. Billy Jean King is one great example. In fact, both T1D and T2D can happen to people of any age. This can sometimes present a problem with diagnosis as some old school doctors will diagnose middle-age people with T2D while it is in fact T1D. I blogged about it here: Can young or thin people get type 2 diabetes? |
I have worked hard to have good control,exercise,trying to eat right for over 20 years. My last A1C was 6.2. When I am in a positive mind all is well. Life is not always perfect. I have been 7.2 , but with medication changes and support life is great. Nancy
I got to see my bro in law recently. His glucose dropped but he did not have his meter to check it. He is on set amounts of fast and slow acting. We know good management comes with the ability to fluctuate but given his mindset, perhaps this is is best for him.
I struggle with this with my daughter, @DrBB–she had gestational diabetes 10 years ago, so after I was dx in 2007, I made sure she was at least aware of the changes I was making. She was attentive and accepting of what I needed to do, but didn’t take it seriously for herself. I even sent her a meter like mine, so that I could send her strips if she was too broke to buy them.
Now she has been told by her doc what I was trying to tell her, and she’s making some good changes without an official D dx yet, so I am hopeful—she had to hear it from a fellow scientist, not an old dancer Mom. But whatever it takes, me thinketh—especially with one’s child!
Ahhh yes, @DrBB—when I was first dx, I had a period where I lived “food is my enemy” religiously. Growing up in dance, I simply ignored hunger. It was a discipline. Besides, it was uncomfortable to dance on a full stomach, so one put off eating for lengthy periods—my sister and I were never anorexic or bulimic–thanks largely to our amazing mom who worked hard to entice us into eating, bless her heart.
Then when I was dx with fibromyalgia in 1996, that all had to change. Most folks associate that with the pain, which is a big part of it, but if you don’t establish a discipline of “tidy” eating habits, you’ll end up with a Fibrofog which mimics the hypoglycemia of a T1 or T2 on insulin—cognitive difficulties, nausea, disorientation, etc…Took me years to figure that out.
I empathize, my friend—very much so!..
I agree 100%, @1DebY—I happened to be looking for a new doc when this shift started to manifest and I fought it as best I could—bringing in my log book, etc. I love my new Doc and she understood, so we agreed to look at the whole picture in our apptmnts, but she still has to follow the A1c policy for official meds and whatever…
I have a lovely, good friend whose brother is in trouble, like yours. She has always been about as round as she is tall, but healthy as can be. Her brother got the T2 gene and didn’t care . Then he got isolated socially and cared even less. And now he has to go to dialysis a couple times a week and enjoys it because he is with people. Of course his sister and I tried to help, but he was too depressed to hear us by that time…
Another great reason for a haven like TuD—at least we have a place for the comfort of like souls…
My Dad was T2 and never on any meds for the D—not even after he suffered the first of many strokes that killed him…My mom cared for him as he deteriorated which was hellish. But, you know what? None of us kids (3 of us) ever were told that he had diabetes. We never knew until after he died…
As the one who got the shallow end of the gene pool and inherited his diabetic gene, my mom opened up to us years after he died…I love your story and wish I had known my own family history…Blessings…
Yes, knowing our family history & sharing that information with our kin is key. After my diagnosis, I made sure that my teenage son knew about his chances of developing diabetes. I don’t harp on him about his food choices, but run a healthy kitchen & set a good example.
I also share my story (when apt) with friends & co-workers. Amazing how many of them have family history of T2, yet shy away from lab work or improving their diet & fitness. I urge people like this to get tested every couple of years.