Do you assume diabetics with horrible complications are to blame?

[BlueberryIsMyFavourite]

I'm just curious about this. And as this is an anonymous forum I thought people would answer truthfully, whereas in person I think people at least sometimes want to be more gentle.

I have type 1 diabetes for a long time now, 28 years, since childhood. I have always been incredibly sensitive to insulin and for a long time in old fashioned terms would have been called "brittle" but doctors don't tend to use that term anymore.

I have very good diabetes management now thanks to new technology. However, plenty of damage was done early on.

There just seems to be a general sense that people think diabetes is quite simple to control, and if you are struggling it's because you aren't doing something right.

Whereas, there are so, so many factors that can cause blood sugar to rise or drop apart from food - as an example, brushing my teeth can cause me to start dropping quickly, which then needs some glucose or juice to treat and stabilise it, and try brushing teeth again later. Because of course, diabetes also can destroy oral health, so good oral hygiene is very important. This is obviously a small, mundane example.

It is relentless and there are no days off.

Do you just assume diabetics with complications are essentially irresponsible?

No. I treat many people with diabetes.

I find the distinctions being made above between T1DM and T2DM ignorant also. And the judgment of ‘non compliance’.

Empathy goes out the window when it comes to some illnesses, and it becomes normal to be rather stupid.

No. Not for type 1 or type 2.

Type 1 and Type 2 are vastly different conditions. My daughter is a Type 1 diabetic and a medical doctor who treats quite a lot of Type 2s. Type 2s can reduce or eliminate their diabetes through diet and exercise.Type 1s can't, no matter how careful they are, and need insulin to live.

My daughter sometimes gets a little aggravated at Type 2 patients who, not knowing she's a Type 1 try to tell her how hard it is. She's polite and professional but she's also thinking, " If I could reverse my diabetes through diet and exercise I would do it immediately, but I can't."

This is my worst nightmare for my my T1D 4 year old. I'm so, so sorry.
As a mother, there is no greater torment than not being able to just take it all away and set your child free from the burden of this horrendous condition 💐

My diabetes is relatively well controlled, and I'm sure when you were first diagnosed it wasn't nearly as easy as now, with hand held glucose monitors and injection pens

Just to comment, we did have finger stick blood testing meters and insulin pens in the nineties when I was diagnosed.

Could never get an a1c lower than 7-point-something with lots of swings with these, despite periods of pretty hardcore low carbing.

Sadly, judging by my friend's experience, some Dr's are rude and judgmental about T2 as well.

No, not at all. It is a tricky disease and difficult to manage. However, I know someone who developed type 2 and was put on insulin to stabilize. Instead of modifying his diet he continued to eat what he wanted and just injected more insulin to compensate. He has now lost both legs, has had quadruple heart bypass surgery and stents, and is in kidney failure. Still eats what he wants.

Type 1 diabetes is no more avoidable than something like asthma is. You either have it or you don't, and either condition can be well-controlled depending on the medication available and the person's own common sense. To clarify - in either case it's a condition that is lifelong and is life-affecting.
Type 2, as other apps have said, I'm not so sure I'm as sympathetic to. It can be controlled by lifestyle changes.

Im.aware of that my Dh has type 2and it can be reversed.with diet etc in his case but I know its not always just due to.life style but type1is auto.immune and can't be reversed.

I've never actually thought about it. I'm actually surprised other people (who are not diabetic) have

Please educate yourself.

Type 2 is much more likely in Asian people.

How do they avoid being Asian?

I’m a GP, and the reality is that most diabetics who end up with awful complications either end up that way because their diabetic control is rubbish and their sugars are way out of control (which is usually because they aren’t taking their medication and attending their appts etc let alone being careful with their diet) or because they’ve simply had diabetes for a very long time (like decades).

If you’re type 1 then usually you’ve had it since childhood and you live with it for decades longer than the average type 2 person.

So basically I would be much more likely to think someone with diabetes is ultimately “to blame” for suffering complications if they’re type 2 and haven’t had it for decades already. I certainly have some type 2 patients who have suffered awful complications fairly early on and it’s usually been very obvious for years that they were heading in that direction but our advice has fallen on deaf ears.

Having said that, I understand that it’s a really difficult illness to have and I would absolutely hate to be diabetic myself, I think I’d find it extremely difficult to manage, and I’m very grateful that it’s not something I suffer with even though I’m overweight.

And it’s not even as simple or straightforward as saying that the diabetic patients I have who have been running off the scale high for years and end up with complications are “to blame”. There is usually a reason why this happens, and it’s often simply a reflection of poor mental health and them generally just not coping and responding by burying their head completely in the sand and being in denial about the long term effects of ignoring their diabetes.

The saddest ones are the type 1 teenagers who simply can’t accept that they have to take much more care of their diet and drinking and have a more regimented lifestyle etc. than the average teen, are in total denial over it all in teenage rebellion mode, and end up in DKA let alone with long term complications. I will never forget one of my teen diabetic patients, I had been warning her for ages that she was going to wind up in a coma or with serious complications if she didn’t start to pay
more attention to her diabetes and take her insulin properly, and then I got a letter from the hospital saying that she’d died from DKA. Do I think she was “to blame” for going into DKA through neglecting her diabetes? Yes sort of, in that I was shocked but not surprised that she died, my colleague said one of our teens had died from diabetes and I immediately knew who it would be. But I also recognise that most teens go through phases of doing stupid things and not doing what they’re told and most of them don’t die as a result. It was just really sad. She was only 14.

I'm a type 2 diabetic, have been for 15 years. As was my father, his mother, her mother.... strong family history. And it really pisses me off that people dismiss it as something I've brought on myself and am too lazy to bring under control. I've lost 5 stone, but am still am struggling to control my blood sugars in spite of barely touching carbs, walking 12k steps every day and weighing/measuring everything I eat. It's miserable, frustrating and something I'd really happily live without.

This isnt' always true. I'm at higher risk of type 2 as I take corticosteroids and I can't move much due to disability.

My weight is within acceptable ranges (it did go up when I was extremely unwell with arthritis and was on heavy doses of steroids).

You either have it or you don't, and either condition can be well-controlled depending on the medication available and the person's own common sense

Sometimes it cannot be "well controlled" with medication (insulin) and common sense. That's the point.

My insulin pump and cgm are the only reason I cope as well as I do nowadays.

Blood sugar can change so rapidly for so many people, for me and many others being on insulin injections without a cgm was/ is a constant game of russian roulette.

Thank you it was horrible ,and there was no known cause.of the acute pancreatitis or why his pancreas was necrotic ,it was incredibly rare due to his age thankfully he's adjusted well and doing well And has Been funded for a Dexcom but it's been life changing .

Absolutely not.

@thermalvestwearer ", you've misread me - I said not as sympathetic to, as in some people have it and make no effort to do something about it. I maybe should have said that for clarification, but didn't think it was necessary at the time.

Definitely not. A good friend of mine with type 1 died in her sleep a few weeks ago from diabetes complications.
She had all the new technology.

I’ve had T1 since I was 10 and am complication free. I drink, eat what I want, but I do exercise and def monitor my levels carefully. I have an insulin pump and a CGM which help massively.

It def hasn’t ruined my life though!

@vipersnest1 you said Type 2, as other apps have said, I'm not so sure I'm as sympathetic to. It can be controlled by lifestyle changes.

In my case, my risk is substantially raised due to arthritis. There is nothing I can control about that if I get it. I can't not have arthritis. What lifestyle change would control me not having arthritis?

My DH has type 2. He is as skinny as a rake, never been overweight, doesn't overeat, smoke or drink. It is really hard to manage his diet because he really can't afford to lose weight. He does everything he is told to do. There is certainly no reason to think he is responsible for his condition.

DH is T1 as well, and like you the damage was done long before the new technology. He now has PAD, tiny bit of macular degeneration, his main trouble is exocrine pancreatic insufficiency which was probably not caused by the diabetes, but may have been pancreatitis that possibly triggered both complaints, no one knows!

T1 is like herding cats, even knowing exact carb counts means fuck all, as there are so many variables. It is exhausting, and you never get a day's respite from doing complicated calculations. I've seen DH desperately hungry but can't eat because of an unaccountable hyper, and had to inject him with Glucagon for unexpected vicious hypos. Honestly, anyone who remotely judges someone with this shitty illness boils my piss so bad.

Much love to you and other sufferers xx

@BlueberryIsMyFavourite, again apologies that you've read me wrong. I did say with medications available, etc. I know someone who has brittle asthma and how quickly her circumstances can change. What I didn't know is that the same applies for type 1 diabetes.

I’m type 1 and if I mention my diabetes to someone who doesn’t know I find myself saying I have type 1 diabetes, not just diabetes. I’m overweight, which is something that happened long after I was diagnosed at the age of 18 and hate people thinking that I have done it to myself. I know that isn’t the case with type 2 but there is an undercurrent of ‘this is your fault’ with type 2 in the media and general public.

Not long after moving to a new area I had to get a diabetic eye screening. I went to the local optician to book in and he queried why I needed it as (apparently) they aren’t routine for type 2. I pointed out that fat people can have autoimmune conditions, I wasn’t fat when I was diagnosed, not that it was any of his business and I would expect him as a medical professional to understand that there are two very different types and causes of diabetes before flouncing out in front of a waiting room of patients. Probably Unnecessary but it felt good at the time.

I’ve was prescribed contactless glucose monitoring just a few months ago. Seeing the triggers for my sugars to go up and down now is a steeper learning curve than when I was diagnosed 20 years ago. Then it seemed pretty easy and simple, now I feel like I’m constantly fighting highs and lows. I also hate constantly explaining why I am eating what I am eating to people - someone sees me with a bar of chocolate and comments along the lines of ‘should you be eating that?’ I carb count and can adjust my insulin to cover something like a chocolate bar, i basically eat like someone without diabetes, except I’m constantly working out carbs and calculating ratios and justifying my choices to people.

Those of you who have Type 1 and have kids, have you looked into the ELSA study? It looking into genetic markers for type 1 and is signing up children for a simple blood test. Last time I looked my kids weren’t eligible as it’s not open to Scotland yet, but I’m hoping to be able to sign my own kids up when I can as my family history of type 1 is terrible.