I worked at a patient program the other night for my company, and shared information about our two medications. One medicine we make is for Type 2 diabetes, the other can be used in both Type 1 and Type 2s. The presentation that night was about healthy cooking tips, and the audience furiously jotted down notes as nutritionists and chefs prepared tasty and healthy dishes from the stage. During the breaks between presentations, patients came by the vendor tables to learn more about our products. In order to provide the appropriate information to patients, I’d ask if they were a Type 1 or Type 2.
And this is the part where I got truly surprised. I was shocked at 1.) the number of Type 2s who did not know what kind of diabetes they had (all the Type 1s responded quickly and confidently), and 2) How many of the Type 2s said they “weren’t a Type 1 yet because they weren’t on insulin.”
Huh? Last I checked, types of diabetes were defined by their epidemiology, not their medications. Yes, it’s true that all Type 1s have to take insulin because we don’t make it, but that doesn’t define why we’re Type 1s. We’re Type 1s because we have an autoimmune disease that stops our pancreas from making insulin. Period. Type 2 diabetes follows a different pathology altogether. True, Type 2 is a degenerative disease, and many with it will “end up” on insulin because their beta cells eventually putter out completely, it’s still different from the autoimmune attacks of Type 1s. I’ve always felt that the two types need different names, and this misnomer that the disease is defined by what medication you require just reinforces the fact. That said, I understand that some make the case that since the poor outcomes of diabetes of all types can be the same, they really are just “variations” of the same disease. I completely disagree, but I can see how some people go there.
What I can’t understand is how so many patients don’t know what kind of diabetes they have. And I think the blame needs to be shared here across health care providers, the patients, and media/stereotypes/damn Steel Magnolias again. The overwhelming number of diabetes cases in the U.S. (about 95% in fact) are Type 2, which means that if you generally use the term diabetes, you’re likely to referring to a Type 2 case. But this sweeping generalization is where hurtful stereotypes come in to play – for both groups of patients. Type 2s get cornered into thinking that going on insulin means they have “the bad kind” of diabetes, and Type 1s get asked what they did so badly that they had to go on “the needle.” The confusion around the differences is tough on patients, because it perpetuates the untruths abounding about both types of the disease.
And here’s the part where I don’t know what to do about it. Which I suppose is why I’m on this blog complaining about it. It frustrates the heck out of me that there’s not enough education about a disease that 25 MILLION people in the U.S. have for them to understand which Type they have. And it makes me feel defensive about my bum pancreas and super-charged auto-immune capabilities. I did my best to educate folks the other night, but at the end of the day, what we’re doing for diabetes education as a country isn’t enough. And if we’re not careful, we’ll literally sink this nation with the costs of simply not knowing enough.
