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?

It's incredibly difficult to control type 1 diabetes.

Normally, your pancreas drips out the right amount of insulin to match your blood sugar.

But people with type 1 diabetes have to inject once before a meal. This means there's often a timing mismatch because 2 meals with the same carbs could release carbs and spike blood sugar at completely different rates.

50 years of these mismatches mount up to mean someone goes blind or loses a limb.

That's someone who has done everything right and being slim/exercising would make no difference.

In fact exercising often makes it harder as it affects your blood sugar and often causes a spike. Again, non diabetics would have their body adjust automatically.

It's patently ridiculous to judge a stranger for such a complex disease when you have no knowledge of what factor/factors contributed to it.

People are so defensive about the word judge. But that’s the point. I understand the T2 might be down to age. I use my judgement when someone says they have T2 to see they are clearly older and probably it’s down to age. Like their hearing or joints going . Similarly when I see someone who is clearly apple shaped or generally fat saying they have T2, I would judge they need to cut down on carbs. Usually they then complain about their dodgy knee. They know as well as me losing a few stone would help with both. I’m not perfect being both fat, apple shaped with south Asian descent. I’m a realist though.

Things have moved on a,lot in the past 30 years in the Treatment of Diabetes as I posted up thread my son was diagnosed with type 3c diabetes in February ( treated as type 1) yes its difficult and as his mum.im.constantly worried about this blood sugars ,probably more than him
But he has a Dexcom ,funded by the NHS ,which is very reassuring for me
I'm very proud of him tbh ,he's dealt with it very well considering he's only16.

No. Even if people appear irresponsible, there can be reasons for that - if nothing else having a chronic health condition is highly likely to effect your mental health.

I too am sorry that @CentrifugalBumblePuppy has such unfortunate health. Clearly some are luckier than others and it makes a difference.

But they also wrote in their post that “I have met so many older type 2s at clinics who don’t monitor, who think that Metformin makes it OK to eat cakes, sausage rolls, biscuits etc.! “.

Which sounds like judgement to me.
(If I wrote that people would tell me not to look, I don’t know what they have going on at home and maybe that’s all they have/ can afford etc etc).
Diet is a major factor. Is all I’m saying.

Sadly dexcom isn't available for most people on the NHS. My son has just gone onto a pump but he still needs to tell the pump what to give him.

Type 1 no, type 2 I would need more on the specifics. It can be brought on by people not managing their diet in which case yes but the picture is not always that clear cut so it would very much depend on individual circumstances.

Diet may be a factor in some cases, maybe even most cases. But it is not a major factor in all cases.

You shouldn't say "diet is a major factor". Because that's not true in all cases.

Type 2 is complicated. I think it’s really upsetting for people to say it’s the persons fault they have type 2. If you research it diet can be a factor, but also genetics and just bad luck.

I have it in my early 40s and not overweight and not been ever in my life, do exercise and generally eat healthy. Mine is controlled by lots of medication as diet and exercise alone didn’t help. Typical medication didn’t help, so I am in about 4 tablets a day and watch my diet.

took me a while to accept my diagnosis and generally stop blaming something that was genetic

As a T2 diabetes sufferer it depends. T2 is largely preventable - god knows I caused my own. It's also easy to get under control if you're willing to do what it takes, but many aren't. I have a lot more sympathy for T1 sufferers personally. T2 sucks but there's a lot you can do to turn it around and in my experience, many don't!

@BurbleBumleBleep

thanks the patronising really helps.

if you had read my message properly, you'd have seen I WAS slim before I got T2, through a couple of virus attacks. It then caused me to gain weight. I am now fat, so people, like you, judge me to have caused it myself through laziness & diet.

stop judging people you don't know. It's not difficult not to be a judgemental moose, it IS difficult being judged for something that's beyond your control.

Ah yes that lifestyle choice of being South east Asian, why can't they just try harder to be Caucasian, its clearly their own fault...

Being T2 yourself, doesn't make you an expert on everyone with T2.

when mine was first diagnosed I was able to get it back into 'normal' with diet & exercise. 25 years in my body continues to react differently too various things & it no longer responds so well to diet & exercise. I'm currently still not on medication, but my numbers are not so good.

peopke coukd just mind their own fucking business & not judge my medical condition or my body FFS

From a professional point of view, many people who are diagnosed with type 2 are not given adequate education on the condition, or are unable to fully understand the seriousness of complications.
So I don't think it is entirely always their fault.

my daughter was diagnosed aged 18 and i'm embarrassed to admit that I initially assumed her crappy diet was to blame: pizza, takeaways and the usual teenage crap. Despite her being a slim size 8 and healthy bmi. The doctor explained that it wasn't preventable at all and I was gobsmacked as I'd always assumed that it was lifestyle related, which is nuts when you consider that small children and teenagers are diagnosed with it.
Lots of ignorance about T1D, from a personal experience perspective. More than one GP, when reading in her notes that she's t1D, have asked her if she takes anything for it. Err yes doc, or I'd be dead.
The psychological weight of T1d is massive too: you can't take your eye off even for a second. It's relentless. She's got an omnipod pump and dexcom which makes
life easier, but life is never easy easy, in the way it should be for a 20 year old woman.

Do you have xray vision to see their genetics or other conditions that can trigger it?

My child has T1D since very young. It's relentless and I'm thankful for technology. It's very much a psychological burden, and so very hard for young teens and young adults who are passed over complete management once parents step back. It's a difficult transition, and a hard age group to manage.

I know a fair few with T2, and it's such a mix. You've those who know about management and choose to ignore, but also many who aren't well informed or given guidance. Those I know were diagnosed and sent off with a diet plan and 6 month check. Many on metformin think that's what's keeping them in check and they don't need to do anything. Most patients will just take what the GP says and carry on, they don't necessarily seek extra support. Our blood glucose levels go up and down continuously, it's impossible to 'feel' what level it is at a given time. So many T2s who constantly have high levels are none the wiser and aren't given any tools such as strips and meters. So I have a lot of sympathy. The NHS is so overwhelmed.

Not to mention NHS "diet advice"

Low fat shite & artificial sweeteners were recommended for years, and I'm still not convinced dietary advice is where it needs to be.

Absolutely no judgement! Just showing that lack of monitoring and education for people with type 2; I was offered zoom group chat sessions, older folk who get diagnosed may feel excluded if they don’t have the technology to join the sessions, or have communication issues. Face to face groups would be more beneficial but not offered currently at our Trust.

Some people just don’t engage with any offered help (DDad as a great example), and then, in his case, ignore the warning signs of infections (like Dad, put it this way he ended up unable to play ‘This little piggy went to market’ as most of the piggies had gone into medical waste, and wet gangrene is a smell that’ll never leave my nostrils).

Education is key here. Standing in a car park, trying not to spew (Metformin and one of my pain killers don’t play nicely together some times) and I was chatting with a guy who was eating a sausage roll and a Belgian bun. I knew I was going low, whipped out my kit & surreptitiously tested; the guy looked at me & said; “I’m diabetic too! My Metformin pills mean I can eat anything!”.

No judgement at all, just an urgent need for education. If you use a glucose monitor, it is a tangible metric by which you can understand how your diet/exercise/pain/lifestyle affects your glucose levels; perhaps it brings a sense of gravitas & a dose of reality to being type 2. Many folk of my parent's generation have the attitude that by taking a pill it makes everything better (talking to older friends/relatives and their friends) but with diabetes you may need significant changes in your whole lifestyle.

If anything, seeing people at the diabetes clinic talk about their buns & biscuits (or the sausage roll dude) make me judge the NHS because they are failing or have a problem engaging & educating people who have a type 2 diagnosis.

As for the Chronic Kidney Disease (I’m only a couple of months in) I received a lovely brochure style booklet in the post. I’m a bookworm & read everything (same for the diabetes bumpf) but some people can’t or won’t. Again, education to help people navigate & manage their condition would surely help lower hospitalisations and treatment costs.

Tl;dr I’m judging the inability of the NHS to provide engaging education of Type 2s, not the poor folk who are none the wiser & have the disease.

Type 1, no. I've worked with children and their families who've been suffering for years and it's just so hard to manage.

Type 2, sometimes.

(my mum was horrified when her oncologist pointed out that pretty much all her health complications - COPD, bladder and lung cancers - were connected to her smoking 20 a day for 20 years.)

That said, if we all lead perfectly healthy lives, ate 5+ veg a day, 2l of water and no booze, plenty of exercise, we'd still get ill. But lots of health conditions are brought on/exacerbated by lifestyle choices so...

DH has had rubbish dietician experiences, he has worked out so much himself from trial over the years. His mum ‘carb counted’ obsessively and yet had constant hypos, because she was following dietician advice. As DH has discovered, all carbs are not the same so you need to assess everything.

The worst experience he’s had though is when he’s been in hospital. They seem completely clueless. Last time he was in they told him to manage himself and left him with all his stuff which was fine. A different stay in a different hospital they insisted in locking it all away and them administering it, kept trying to give him insulin injections before dinner had even arrived on the ward sending him into huge hypos. It caused a huge row and a consultant from the diabetic clinic had to get involved as they admitted ‘didn’t understand his insulin’ and were just trying to give him random amounts.

I have similar. I really resent the implication. Had it 50 years, since the age of 1. Mine is impossible to manage, despite all the latest tech, mine is very brittle, unpatternless and a pain. My old consultant says I've been a case study at many conferences. They still don't know what to do with me. So what I dint need is others offering opinions, or judgement.

No. I am aware that illness is often hard to control- or there would be far less illness of all sorts, as who wants to be ill? Sadly, I did know someone who died quite young, mainly because she totally ignored and defied all medical and dietary advice about controlling her diabetes. So sometimes people's choices can contribute to the prognosis - but the same can be true of any illness. Unfortunately, some people are particularly self-righteous about diabetes because they associate it with obesity and consider obesity as a crime rather than a health problem.

Plus the fact that many people don't differentiate between Type 1 and Type 2, and/or are unaware that Type 1 can strike for the first time in adulthood. I have known three people who developed Type 1 in their 40s or later (two of them were mother and son; the other also had a family history).

Totally agree OP. It never helps those people to shame them over something beyond their control.
It just makes matters worse 😒