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?

I second this. As type 2 for 20 years, on insulin for 14 years. Massive insulin resistance, consultants unable to suggest anything to help (tried all other drugs on the market, none have helped). GP just tells me that I need to try harder.

My father died of t2 diabetes complications. He was slim, ate all the right foods, exercised and was very careful with his medication. He had t2 for over 25 years but it got him in the end. I would not judge anyone.

But how could anyone blame a slim, sporty, healthy individuals for having it?
Its also perfectly possible to get Type 2 through lifestyle choices and it’s pretty obvious where that’s the case.
I mean people do get lung cancer through no fault of their own and some people get it from smoking 20 a day. Not to say the smoker wouldn’t have got cancer but certainly they actively upped the odds by smoking.

No absolutely not. Friends lost their teen due to the disease so I'm well aware of how grave it is.

@LonelyFlans have you tried ozempic/trulicity? It's fairly successful but side effects can be pretty brutal (gastroparesis/hair loss/upset stomach)

Type one since I was 3, now 35, rebelled in my teens, told myself that future 'to themoonandback' would deal with it 🙈, managed it incredibly well when when I was pregnant, to the point that the specialists caring for me told me to ease up a little as they were worried I would become hypo unaware, now I'm a mum to a four year old and it's relentless, I'm not badly controlled in any sense, but sometimes things slip and my hba1c levels are slightly higher than I'm used to. I'd hope no one would judge me as I'm still learning new things about my own body every day. Periods (when I have them) affect me differently, going shopping for longer than I thought, taking my DD to school, working different shift patterns, meeting friends at the drop of a hat, the frikkin weather!!!! you never know how your body is going to manage it x

Yes I have - they didn't work for me at all. Horrible side effects and no benefit.

There's pretty much nothing I've not tried...

I don’t judge people with type 1 diabetes. Type 2 I can be a touch less sympathetic sometimes… but that’s mostly because my Mum had type 2 which she fully caused herself, gave zero fucks about, and surprise surprise when she suddenly dropped dead last year there it was on the death certificate we had to wait 2 months for thanks to the need for an autopsy, along with coronary heart disease, hyperlipidemia and kidney stones.
There’s a chance this has skewed my perspective.

Correct I have mody diabetes which os a genetic type!

It's very frustrating. We have family members with Type 1 and Type 2, not to mention 2 others with pancreatitis. It seems we have a propensity in our genes, which is being checked.

But the assumption that it is 'easy' to deal with doesn't take into account that it varies widely.

I'm type 2 diabetic. I am underweight and have a range of immune conditions and have had to take steroids as part of my treatment for over 20 years. This has made me diabetic through my medication.
I have come of my insulin twice in the past 13 years. The first time was for 9 years, my doctors never thought that would happen. Anyway it won't happen again my Pancras has been destroyed through my medication that I'm am reliant on to survive.
I really won't appreciate any judgment of me because of my diabetes. I didn't do anything to cause it and my every day like is now trying to control it, in combination with my other conditions.

No type 1 diabetics are not to blame for being unfortunate enough to have diabetes. My niece was diagnosed at 4. As an adult now she has had several hypos and was not able to drive for several years. She's on some new treatment now though that gives her early warnings.

@Anotherparkingthread

i appreciate your honesty, but can you say why?

Im T2. I was slim. I had glandular fever, then another virus that attacked my liver, fucked my metabolism & hormones. Quite the package. This ended up with me being diabetic. Which in turn led me to gaining weight. Drs still just scratch their heads.

I'm hoping some of the research around covid leads to some answers.

which part of that was my fault? Why do you judge me?

@BlueberryIsMyFavourite this is such an excellent and informative thread, thank you so much for starting it.

Not type 1, no.

My DH has Type 1 and I know through him about how mental health and other difficulties can cause really poor control e.g. teenage girls having "bulimia" through letting their sugars go high all the time and some going blind.
So no, I don't blame them.

I'm a type 1. I manage it as best as I can, carb count, try and limit my carbs, eat wholemeal instead of white etc.
But even trying to manage it doesn't work. Being on insulin isn't some magical cure, I can eat the same thing one day and be fine, the next day it can spike me.

It's a horrendous condition that feels very lonely. Medical professions try and help but I think unless you live with it it's difficult to understand it completely. The theory is one thing, the practice another.

As someone said earlier, there's lots of factors that influence blood sugar. With other illnesses a doctor would say, take xxx pills but with insulin no one can tell me my ratio, my dose, why one day it works and one day it doesn't. So I keep trying and hoping that even if it's not perfect I'll minimise damage. But I know I'll probably end up with complications eventually.

It's upsetting to read from a pp who is a gp that when T1s are poorly managing their condition they do think they could have avoided their complications. I carry the weight of potential complications with me daily and want to stay in target but my insulin doesn't work the way I'm told it should by medical professionals.. no matter what the theory says.

Reading this I realise I know very little about it. The signs were drinking lots and going to the loo. Embarrassing how little I know.

I thought I knew one could be caused, and prevented, by lifestyle changes, and I know of someone who says they are on the cusp of one type (they're overweight and drink excess alcohol).

OMG that's horrific.

I've a friend with type 1, diagnosed at 7. At 14 was only doing injections when mum was nagging. His consultant told mum to back off, let them get ill and a proper fright, with the logic it's better to have one scary moment than cause lots of damage skipping injections.

Proper fright was had and they were shocked into taking 100% responsibility for their own health.

But I also know of a young person who died recently, for years breakfast was a sugary cearal, except they have cut the sugar content. They struggled to get the balance right.

@DaftQuestionForToday I assumed @Anotherparkingthread is talking generally.
If you are underweight/ have other conditions clearly have T2 diabetes might be as a result of something being mucked up you can’t control.
T2 Diabetes is undeniably linked to lifestyle regardless of the percentage that don’t have it because of diet and exercise.

Not at all. Type 1 is an autoimmune disease and often quite difficult to control. As a previous poster noted, the difficulty comes when teens (quite appropriately) start to take over the management of their condition, long before they are cognitively able to make the best decisions for themselves.
Type 2 is not simply a lifestyle disease and there are many factors that contribute to someone developing it. For example, I commonly encounter patients in hospital who have a completely normal BMI but are of Asian descent with T2.
We have such a poor understanding of obesity and appetite that we are not very effective in simply advising people at risk of or suffering from T2 to eat better and exercise. I cared for a man who was on strict bed rest and a hospital diabetic diet due to diabetic ulcers. He was on the precipice of having both his feet amputated but he begged me to take his coins and get him a full sugar lemonade from the vending machine. To my mind this is very clearly the result of poor mental health and hopelessness.

Not something I think about much. The few people that I know who have diabetes seem to manage it ok.

I must say the posts about complications of T1s has scared me!

DS (13) was diagnosed a year ago and it’s a constant battle to get him to inject for everything he eats while trying to avoid an eating disorder developing. As a teen boy who’s already 5ft 10, wants to rummage through the fridge and raid the biscuit jar as any other rapidly growing teen does. His time in range has been crap with that and hormones (which also affect levels, we’ve been told for another 3-4 years!), school stress etc.

I mean who the hell wants to inject 6-8 times a day, can’t put anything in your mouth without calculating the carbs, trying to remember where you last injected, constantly having to be alert for sudden lows and feeling like crap if you can’t get out of a high. Thankfully DS has a CGM and I can’t imagine how bad it would be if he didn’t.

Obviously we know there is new tech now (closed loop system) which can significantly increase control and prevent complications, and which will be a massive cost saving to the NHS and the effect on people’s lives, but it’s not available to everyone!

@Willyoujustbequiet in retrospect I wasn't expressing myself very clearly here. I’m certainly not trying to victim-blame this 14 year old, I agree her executive function wasn’t fully developed and yes she was also let down by the adults around her, the whole thing was an absolute tragedy.

Just (I agree very clumsily) trying to say that even when someone isn’t managing their diabetes well and suffers complications as a result, even then it’s not always their “fault” or they aren’t “to blame” as such, there are always reasons why they aren’t managing their diabetes well and someone without diabetes might act similarly but does not have to suffer the same consequences. It’s just an awful illness.

@Ineedaholidaynowplease I understand it can be very complicated and difficult to manage diabetes especially as a type 1. Just saying that the reality is that people are more likely to ultimately get complications if you have diabetes for decades (like most type 1s unfortunately) or if you have long periods of poor control with chronically high sugars (for whatever reason). I do realise sometimes those periods of poor control are not easy to get on top of, especially in type 1. It’s a very tough illness to have. For most doctors I know, diabetes is right up there along with cancer and motor neurone disease etc as one of the worst illnesses to get.