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Original poster

Do you assume diabetics with horrible complications are to blame?

251 replies

BlueberryIsMyFavourite · 21/10/2023 20:38

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?

OP posts:
vipersnest1 · 21/10/2023 21:36

@thermalvestwearer, I have significant arthritis too, so if you find the answer please let me know.

x2boys · 21/10/2023 21:36

Britneyfan · 21/10/2023 21:26

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.

DKA is fucking scary in my sons case it came on over about 24 hrs thankfully he survived and he was diagnosed in DKA .

Shlump · 21/10/2023 21:36

I’m not proud to say it, but I think I do rather think that most people with type 2 diabetes complications could have done more to prevent it. I know it’s an opinion that many would think of as judgmental.

Type 1 not so much. Many people will have had it since childhood, it’s not surprising that they may not have managed excellent control for decades, especially as a teenager.

thermalvestwearer · 21/10/2023 21:38

@Shlump how would I have prevented arthritis? I'm all ears

Insommmmnia · 21/10/2023 21:38

Shlump · 21/10/2023 21:36

I’m not proud to say it, but I think I do rather think that most people with type 2 diabetes complications could have done more to prevent it. I know it’s an opinion that many would think of as judgmental.

Type 1 not so much. Many people will have had it since childhood, it’s not surprising that they may not have managed excellent control for decades, especially as a teenager.

How do you propose I did more to prevent my congenital abnormally when I was a foetus that leads to a higher risk of diabetes?

Or my physical disability which makes exercise harder even though I try my best?

It's not just judgemental. Given type 2 diabetes is higher risk for various conditions and races it's also ableist and racist.

fetchacloth · 21/10/2023 21:39

Iam4eels · 21/10/2023 20:47

While there are risk factors associated with developing type 2 diabetes, you cannot give yourself diabetes in the same way you can't give yourself flu or cancer or dementia. The myth that diabetes is self-inflicted is both insulting and harmful.

Show quote history

I agree about your thoughts on type 2 diabetes. My father developed this after having a stroke. Neither condition was self inflicted , just bad luck.
A close friend of mine has also recently been diagnosed with type 2 and she's a very slim non smoker who goes to the gym 7 days a week. As all the adults in her family have the condition, her consultant believes it's hereditary.
Whilst there are some known risk factors, the popular press has a lot to answer for and the constant bashing is unhelpful 😔

Willyoujustbequiet · 21/10/2023 21:39

Britneyfan · 21/10/2023 21:26

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.

You can have perfect control and still suffer horrific complications.

A 14 year old dealt a shitty hand in life struggling to cope or understand with a complex disease that many doctors don't understand is in no way to blame for her own death. She was a kid with a decade or so before her executive function was fully developed. I would have thought a doctor would be aware of that.

You are victim blaming. It wasn't her fault. The blame lies with the adults around her.

Abergale · 21/10/2023 21:41

I always presumed having to monitor your diet and blood sugar must be an absolute pain so full sympathy here.

Shlump · 21/10/2023 21:41

I haven’t the slightest idea, I wouldn’t have imagined arthritis was a complication of type two diabetes.

I meant only that most complications of diabetes are caused by having raised blood sugars for an extended period of time. If a person has had diabetes for only a few years and has bad complications, it may be partly because they haven’t done all they could to manage their condition.

Obviously it isn’t a fact for every person, no doubt there are unfortunate exceptions.

Binkie98 · 21/10/2023 21:42

I have pre diabetes, and try to manage it with diet, but sometimes I'll eat whole wheat bread and pasta. It makes me feel guilty, but some things I won't give up on.

The problem is that I also have chronic kidney disease, so should limit potassium/protein.

I have high blood pressure so should limit salt.

Pre diabetes so should limit carbs and sugar.

So basically, I'm left with lettuce leaves. Sorry but no. (I'm in my seventies).

Shlump · 21/10/2023 21:42

@thermalvestwearer sorry, post above was in reply to you.

Hapshepsut · 21/10/2023 21:42

decoratorsinprogress · 21/10/2023 21:35

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.

Show quote history

In his case, no, but in my case I was massively obese for years and did nothing about it

TheresaOfAvila · 21/10/2023 21:44

jlpth · 21/10/2023 21:16

Would you blame someone for having anorexia? Or having an addiction problem? Would you say the anorexic should just eat or the addict should just stop?

Type 2 diabetes can certainly be a result of lifestyle factors and very often is. But people are different. Very different. People have extraordinarily different drives to eat, people have very different personalities - addictive type for example, people have different circumstances - depression and shit things happening to them which drives them to comfort eat or whatever. And let's not underestimate the genetics - I know a bloke in his 60s, very lean and exercises every day. He has really bad type 2 diabetes that he struggles to control.

You shouldn't blame anyone for illnesses, or complications resulting from illnesses.

I don't have diabetes btw.

Show quote history

I think that’s quite infantilising.

I know that there are soft factors which impede people capabilities to cope with their disease. I had a colleague for whom having a chronic illness was such an attack on his masculinity that he went blind, and had to have both legs amputated and still he couldn’t engage with it. The huffing and puffing about his sugars was, quite frankly, ridiculous.

That man, (and he would have this in common with people suffering from anorexia) caused extraordinary levels of distress to his spouse/children and his poor living mother. He cared not a whit, and god help anyone who suggested he might think of his kids. He absolutely was to blame for that, and sanctifying his illness is a further slap in the face to those he made watch him die like that.

I don’t think he is in any way representative of people with diabetes, but among those who suffer the most serious consequences are more of those who are not prepared to engage with the reality of their illness.

icebearforpresident · 21/10/2023 21:44

Shlump · 21/10/2023 21:36

I’m not proud to say it, but I think I do rather think that most people with type 2 diabetes complications could have done more to prevent it. I know it’s an opinion that many would think of as judgmental.

Type 1 not so much. Many people will have had it since childhood, it’s not surprising that they may not have managed excellent control for decades, especially as a teenager.

Type 1 not so much…

Type 1 diabetes is an autoimmune condition where the pancreas stops working, the case I use to carry my insulin says Dead Pancreas Club, because it doesn’t function anymore. There’s no more I could have done to stop myself getting it than there is a way to stop gravity existing.

Insommmmnia · 21/10/2023 21:44

Shlump · 21/10/2023 21:41

I haven’t the slightest idea, I wouldn’t have imagined arthritis was a complication of type two diabetes.

I meant only that most complications of diabetes are caused by having raised blood sugars for an extended period of time. If a person has had diabetes for only a few years and has bad complications, it may be partly because they haven’t done all they could to manage their condition.

Obviously it isn’t a fact for every person, no doubt there are unfortunate exceptions.

You can have damaged caused over the long term by a mildly raised glucose level that doesn't cause symptoms and by the time it's found the damage which causes the complications is already done

So you are basically judging some people for not being psychic about a disease they don't know they have and that they have no symptoms for

thermalvestwearer · 21/10/2023 21:45

Shlump · 21/10/2023 21:41

I haven’t the slightest idea, I wouldn’t have imagined arthritis was a complication of type two diabetes.

I meant only that most complications of diabetes are caused by having raised blood sugars for an extended period of time. If a person has had diabetes for only a few years and has bad complications, it may be partly because they haven’t done all they could to manage their condition.

Obviously it isn’t a fact for every person, no doubt there are unfortunate exceptions.

Arthritis isn't a complication of type 2 diabetes.

Type 2 is a possible complication of arthritis, if you have extended use of corticosteroids.

SemperIdem · 21/10/2023 21:45

I don’t assume they’re to blame, no.

I think, prior to reading your post actually, that I did underestimate the relentlessness of managing type 1 diabetes.

Anygoodidea · 21/10/2023 21:46

No.

Spacecowboys · 21/10/2023 21:48

No I don’t assume that. But for some people who have type 2 diabetes it WAS avoidable and is the result of poor lifestyle, diet and being overweight. Bad habits then continue following their diagnosis and good control is never achieved, with the resulting complications. It’s important that people realise this tbh.

Shlump · 21/10/2023 21:50

icebearforpresident · 21/10/2023 21:44

Type 1 not so much…

Type 1 diabetes is an autoimmune condition where the pancreas stops working, the case I use to carry my insulin says Dead Pancreas Club, because it doesn’t function anymore. There’s no more I could have done to stop myself getting it than there is a way to stop gravity existing.

Show quote history

I think you’ve misunderstood my meaning. I don’t blame anyone for developing diabetes, but particularly type 1. My understanding was that the theme of this thread was discussing diabetes complications, not the condition itself.

DutchCowgirl · 21/10/2023 21:51

My mother suffered from diabetes type 2 and also depression and binge eating disorder. Not a great combination. She died of the diabetes complications. But I don’t blame her for it! It wasn’t something she could help! If anything i would blame her doctors who didn’t refer her properly. She lost a leg because she got help too late.

ChokeToDeathOnThreePoundsOfMeat · 21/10/2023 21:52

I have a cousin who has brittle diabetes. Having grown up seeing her struggle with it, I would never presume to judge someone with diabetes (or any other chronic health condition) for being unable to completely control their condition & their health.

Housesellingnightmare · 21/10/2023 21:53

This reply has been withdrawn

This has been withdrawn by MNHQ at the OP's request.

bruffin · 21/10/2023 21:57

I know a T1 young man age late teens who ended up in hospital because he blood sugars were all over the place. He got told off for not looking after himself, turned out his strips were faulty and he it wasnt his fault.

I got diagnosed type 2 last year after i ended up in hospital and went straight onto insulin. My diet is wasnt bad but now it's really healthy but i havent lost any weight, but we have a very strong family history of type 2.

Lots of things do affect my blood sugars not just food. Hot weather really makes my blood sugar low, excercise also brings my blood sugar down.. Ive halved my insulin dose since i came out of hospital and my Ha1bc is in the non diabetic range.

lljkk · 21/10/2023 21:58

T1D is just crappy luck whether you get it, isn't it? And it's hard work to take care of not let it escalate.

There can be a huge lifestyle element to getting T2D, and the maintenance is a lot simpler (easier to avoid/delay complications) when it's T2D.

I can't think of anyone I've ever known who said that had T2D. So can't form opinions about lifestyles I never observed.

I've chatted to maybe.... 8 people with T1D? 2 of them were sudden onset cases as adults. None of the people who I knew with T1D had complications, so can't really have an opinion about that either.

I guess that's a resounding No from me to OP's question.