I've had a couple of comments on my post about the proposed new HbA1c target in the draft NICE guideline that is currently out for consultation. I was rattling in a 'quick' reply, when I thought - this is *ridiculous*. I can't even see this any more in this tiny box - so I've decided to post it here instead :)
Here are the comments:
Tamer Hassan said... how do you achieve these numbers?
thanks
Tim said... These numbers are impossible to reach... Or at least give me some suggestions on how to reach these levels. Thanks. Tim
'How to reach these numbers' is a question for your healthcare provider really. Don't just ask some random nutter on the Internet! However (and desperately trying to avoid sounding like Mr Smug of No 22 Smug Gardens, Bigheadshire) I have had a sub 6.5% HbA1c for over 3 years now, so I know that it *is* possible if only perhaps for the lucky few. Plus I've never had fewer hypos in my life with diabetes either - so it's not that I am 'paying' for A1c improvements with the hefty cost of Severe Hypoglycaemia.
I cannot really tell why some people seem to put in so much effort and get such scant rewards, and that is why I think individualised targets are SO important.
But it does seem pretty clear to me that the closer you can get to those standard-issue BG targets (5-7mmol/L waking, 4-7mmol/L pre meals and <9mmol/L by 2 hours after meals) for as many days in the week as you can manage, the closer you will get to these kind of tough, aspirational, borderline non-diabetic A1c targets. My own HbA1c has fallen by around 1.5% in recent years, and I think only around 0.5% of that is attributable to the pump - though Artoo has gone a LONG way to reduce my number of irritating low-level hypoglycaemia dips. When I look back over the changes that I have made in recent years I can see a few things that I think were important. I don't offer these as any kind of guide or advice - it's just what I did.
Education. Get access to proper structured education regarding diabetes management. In the UK we have DAFNE which is highly thought of, but other options are available. Things that should be included (in my opinion) are:
carbohydrate counting, working out how to check and change insulin:carb ratios for different times of the day
SMBG technique - when to test and what to do with the results *including* basal testing to PROPERLY adjust basal on an ongoing basis
correction factors - when and how to correct (with insulin or fast-acting carbs) to aim bring you back into range without jumping aboard the gluco-coaster
exercise and alcohol
dealing with illness
If structured education courses are not available in your country/area you can do a lot worse than buying 'Think like a pancreas' (Scheiner), 'Type 1 Diabetes' (Hanas) or 'Pumping Insulin' (Walsh/Roberts) which cover much the same ground. Though the benefit of peer support in group sessions should not be underestimated
Test more often AND RECORD THE RESULTS. Find some way of keeping notes daily as you go along. What you are eating, units and timing of doses (how long before... split doses...), exercise, mood, everything! Without a fairly detailed set of records I find it impossible to see what is going on. Personally I still love mySugr for this.
Gadgets - seek out new tech that can help you manage your diabetes more easily. It might be a 0.5u pen; a smartphone tracking app, or copy of 'Carbs and Cals'; or it might be a BG meter with a bolus wizard so that you can have properly fine-tuned ratios without having to worry about keeping the maths easy. Additionally, ask your clinic about access to Insulin Pump therapy and CGM.
Seek peer support - join a forum or two, join Twitter, read some blogs (thanks!) or even *crazy!* join a local group and meet face to face. Living with diabetes is tough, but it's even harder if you are battling on your own. For everyone there's a little corner of the internet that can provide support, encouragement and shared experiences.
At the end of the day we each have to find our own balance between living a life and managing our diabetes. Somewhere in the middle you'll find your perfect A1c and it won't drain all the joy out of life to reach it.
I was diagnosed at 21, during the final year of my degree. Not perfect timing I suppose, but I recognise that I had it a whole LOT easier than the thousands of kids who are diagnosed at a very young age and who have to try to balance life with type 1 diabetes alongside the unpredictability, raging hormones, growth spurts and peer pressure of school life.
I. Cannot. Imagine. It.
So hats off to Diabetes UK for their 'Make the Grade' campaign which aims to improve the support offered to children with diabetes in schools.
If you'd like to find out a little about what they are doing and why it is so important, they have produced a nifty piece of You-Tubery here:
Some months ago I found myself looking back over the past few years.
If you've read our blog before (congratulations on your uncommon stick-ability) you may remember that we began writing about my diabetes as a family as a result of an unusually nasty hypo. One which made me question whether I was quite as competent at managing my diabetes as I liked to think I was. Posts from others in the household have dwindled rather, and you've ended up stuck with me. Sorry about that. But I look back over the past few years and realise that I have been on a full-on misty-eyed X-Factor-Strictly-Voice-finallist 'journey'.
Learn to muddle along in your own way, with varying degrees of success
Never, or almost never, meet or speak to another actual real-life person with diabetes
Feel slightly isolated and faintly dissatisfied with how you are doing but don't know what to do about it
Lose a bit of faith in suggestions made by various healthcare professionals/clinics/consultants/registrars/DSNs (what do *they* know - they don't live with this day-to-day, harrumph etc)
Carry on for 5/10/15/20 years
*Something* happens
Look for support online and/or meet other PWD face-to-face (eg on DAFNE)
Lightbulb moments ensue
Engage, share, try new strategies, feel empowered
Understanding and management of condition is transformed
Now here's the thing.
This is a pattern I see repeating, time and time again in the experiences of others just as it did with me.
But there are still so many people at point 5 or 6. People for whom the standard structure of clinic appointments just isn't quite working, but who either don't realise that 'peer support' like the DOC exists, or who would run a mile from the very idea of it, believing that it is 'not for them'. I know the second group well. I was a fully paid-up member for all the years that deep-down in my heart I knew I was struggling a little, but made myself believe that 'this was as good as could be expected' and 'nothing works'. Of the 300,000 people living with Type 1 in the UK how many are connected with others? 3,000? 10,000? That still leaves the vast majority 'soldiering on' on their own with only an Annual Review for company.
So what can we do for them?
Don't get me wrong. I'm not saying that peer support could fully replace 'proper' consultations with qualified and well-trained healthcare professionals. I am aware that dark, weird and scary corners of the internet exist, where all sorts of odd ideas are bandied about as fact (though these are hard to maintain in well-populated, mixed groups and in my experience the DOC doesn't stand for nonsense). But I'm also aware that there is nothing quite like hearing experiences of someone in your position, who does live with the same condition as you every day. Who faces the same struggles and has tried strategies that you might consider.
I've also spotted another phenomenon. If you attend a 'meet up' of forum posters, bloggers, tweeters or others who live with diabetes you will not be able to get them to shut up. In fact, you will struggle to get a word in edgeways. Questions will be asked, approaches and strategies compared, support offered, understanding and empathy for the sheer relentlessness of it all given freely.
I'm also aware that every day, up and down the land, dozens of people sit side-by-side with other people with diabetes in stony silence.
And this strikes me as odd. Or at the very least a massive missed opportunity.
I've been meaning to write this post for months, but kept putting it off because I could never quite get my head around the details. To be honest I couldn't even work out a proper title for the post (this you will have noticed). But the time has come to just 'put it out there' to see if some brave Consultant or Clinical Lead can do something with it. Someone like Partha perhaps?
Here it is: Wouldn't it be great if there was a way to harness all those wasted minutes in the waiting rooms at diabetes clinics. If there was some way of facilitating peer discussion and support while we are all sat there waiting for our number to come up. At the very least it might prompt some actual questions to ask in the appointment itself, rather than everyone just sullenly descending into smile-grunt-nod territory.
Something a bit like speed-dating. Sit opposite a person or two for 5 minutes, ask them how they are getting on. How long they have had diabetes. Is there anything they particularly struggle with. Do they have the same problem I do with this or that? What do they do about it? Ring a bell, everyone moves around... 'You'll never guess what that last bloke said...' 'Really? Oh I get that too...'
Of course there would have to be some sort of 'opt out' for people who simply can't face the idea. But I'd love it if we could break the unwritten rule in diabetes clinic waiting rooms that 'thou shalt not say anything to anyone'. For people to be actively encouraged to compare experiences and support each other. So that each clinic appointment would combine the very best of both D-meetups and HCP input.
I had a very interesting conversation with the very lovely Lesley Jordan of INPUT in October last year which made me focus on something I had been mulling over for some time.
It’s odd, because I’ve seen it discussed online and in social media before, often with a level of passion and sometimes outrage that has made me think, ‘Why are you letting yourself get so wound up about that?’
I think it began to make more sense to me when I considered the subject in the light of the way I think about my own diabetes, rather than the words or terms other people might use in conversation or in the media. I think to get too stressed or riled up about what other people say is counterproductive, but I have come to see that it is very important for me to choose my words carefully for the little voice in my head.
I know, I know. Many of you are rolling your eyes, and someone almost certainly just said ‘Oh good GRIEF!’. But bear with me here...
Living with a long term condition like diabetes is hard work. There will be days when you might just breeze along quite happily, barely giving it a second thought, but there will almost certainly be other times when it is a lonely, grim and gruelling marathon – and everything is up hill. It is well established that diabetes and depression often go hand in hand and it is important that we protect ourselves and our sometimes fragile senses of self-esteem. One of the most successful ways of doing this seems to be ‘cognitive behaviour therapy’ (CBT) and an important CBT technique is to adjust your inner voice to help you see situations more clearly and more positively.
I think in words. Conversations with myself. In all the countless interactions I have every day with my diabetes I hear my inner voice commenting on what I am doing. If I am not careful, the background to my every day can become a relentless tide of negativity and judgement.
“I have to test my blood...” “My control is *terrible* at the moment, my BGs have been really bad...” “Well I really messed up that carb count there. I should have weighed it, I bet I go hypo later...”
And all of this spills over into any conversations I have with other people too.
So I have been trying to make tiny changes to the language I use with myself and with others when I talk about my diabetes. These seem so tiny and insignificant that it is hard to believe that they could matter at all, but we have a rich and subtle language and every word we choose conveys complex messages to those around us and to our own subconscious.
So now I am no longer saying I am ‘a diabetic’ – a label which defines me, instead I am a ‘person with diabetes’ – person first, diabetes second.
I am trying not to think about ‘good’ or ‘bad’ blood glucose or HbA1c results. Instead I think of them as being ‘in range’ or a ‘work in progress’.
If you ‘test’ your blood glucose then you can pass or fail that test, so it is better to ‘check’ or ‘measure’ your blood glucose. Check your blood glucose level to give you information about what to do next. Check, respond, move on.
Don’t try to ‘control’ your diabetes, ‘manage’ it instead – there are often factors that affect your blood glucose levels that are outside of your direct control (an unexpected liver dump or some other diabetes randomness), but you can use your skills and knowledge to manage those changing circumstances as best you can.
Even terms like ‘should do’ or ‘should have’ can imply some sort of personal failure if something doesn’t quite go to plan. ‘Can do’ and ‘will do’ are more positive alternatives.
There are also changes you can make in the way you think about food, and talk about it with other people. ‘I can’t eat that’ implies that I am being prevented from doing something and that I’m not in control of the decision. ‘I am not going to eat that, because reducing my carb intake makes my diabetes easier to manage’ or even simply ‘I don’t eat that’ puts me back in control – I am making a choice at that moment and I know why I am making it. Next time I can choose again, perhaps differently, but it is always my choice.
As I say, these changes are tiny. It is hard to believe that they would have any effect at all, but little by little they are helping me engage with my diabetes in a more positive way.
Mine is a supporters voice. As Mike's wife I would like to say I am there to support him in all that he needs. I try; though I freely admit to getting as fed up of diabetes as everyone else, I am not a particularly patient person. Anyway, I think the point is that I try. I'm pretty sure we all want to try, all us supporters; but it is not straight forward.
I recently met with a friend who was diagnosed with diabetes over ten years ago. I visited him in hospital, he had pneumonia along with a heap of complications which sounded suspiciously diabetes related. I asked him whether he had type 1 or type 2. He said, "I don't know." I'm not sure how well I hid my shock, I was pretty much lost for words. My friend lives with his mother. He was diagnosed when he was thirty. He is not adept at communication.
I also know his mother, who I am sure has all the feelings that any mother has when they find out their son has diabetes. I know from Mike's mum that that can include guilt, fear, and the desire to wrap in cotton wool and never let out of her sight ever again. My friend, unlike Mike, did not talk to his mother, and his mother, unlike Mike's, did not like to push for answers to the thousand questions simultaneously forming in her head. She has had to cope alone. She hasn't felt able to admit that her son's inability to communicate has left her at a loss as to how to support him. So what she does is try to look after him. She makes sure he always has a good big bowl of cereal for breakfast, and that there is always a choice of puddings on hand after his evening meal. He happily tucks in. The only piece of advice from a dietitian she has ever been present to hear is that a combination of grapes and banana is a really bad idea.
As the mother of a diabetic diagnosed in adulthood, she has never received any support. Mike's mum was in the same position, but blessed with Mike and then of course I came along and took him off her hands, again with no support and it is scary, but Mike helped me through. I am aware that Mike and my friend are at opposite ends of the communicative spectrum, most people must be somewhere in the middle. Mike is on his way to a long, healthy life, I wouldn't be surprised if he outlived me (my family have a history of heart disease). My friend is on his way to dialysis, losing his sight, losing his feet and dying before his mother. I believe his control would be greatly improved if his mother had been offered support. My guess is that most adult diabetics don't live alone, that many don't cook their own meals, so the responsibility for the control of their condition does not fall entirely in their hands. It can and should be shared.
It's been a couple of months since I've shared anything significant with my fellow readers.
It's not that I don't appreciate you; nor it's not that I had nothing worthy to share. But, as the pressure cooker that is often my mind, I try to give myself some time to digest new lessons or new experiences. Sometimes, those situations are just personally painful.
The last Diabetic Ice Cream Social was no exception. While I truly believe in this event, and what we're trying to accomplish, and while I had many, many supporters, a few things grieved me from it:
The lack of support from other prominent advocates: Honestly, on the regular, I could care less if these folks read my blog, if they like me, or if they think I'm a worthy advocate... but I found it personally disturbing when not many would participate, or share in this particular event -- which was really not about me. It was an event about setting a precedent that we diabetics can manage our own selves, with moderation and self control, and that we don't need to be treated like children (or alcoholics/foodaholics) who can't make food choices -- regardless of what those food choices are. "Ice cream is poison," some may claim, but then why are we supporting efforts to help teach young diabetics to learn how to drink in moderation, and appropriately balance diabetes, but not other types of food choices, instead of just telling them 'DON'T DRINK'? Isn't alcohol a poison, too, and with much more potentially dangerous consequences? ... And I am sure there are many more ice cream eaters than alcohol drinkers out there. (Because you believe in moderation, that's why!) I also don't mind exercising, and doing something to show how a simple modification in my life can control my glucose numbers... but it would be equally reasonable to me (and very realistic) to help teach others there's no shame in enjoying an occasional treat in moderation (perhaps even preventing binges, and eating disordered situations caused by deprivation). I came away feeling many advocates were really more concerned with folks not 'judging' them, and 'tarnishing' their own images, for promoting 'unhealthy habits' than of really wanting to make an impact.
The attack from diabetic food fundamentalists: People who, will not skip a beat to tell you there's no 'diabetic diet,' yet the minute you discuss having a scoop of ice cream, you're called irresponsible, or even childish in your health advocacy... and then take the opportunity to try to impose THEIR personal dietary choices on you, or others (while denying they are doing such a thing -- they are just 'responsibly' telling you that you're wrong). I don't think we can make many inroads into respect for the diabetic patient, and his or her personal choices, as long as these fundamentalist food attitudes are around. The event itself wasn't even about ice cream, it was about food independence -- the freedom to eat what YOU want to eat, as your choice -- in moderation, versus what others want you to eat... And it was just really disheartening to see these kinds of folks mud slinging the event, or myself, in blogs, etc., as someone intent on promoting an 'ice cream eating binge' that further creates more diabetes. Yes, the same people who speak of food and sugar not causing diabetes, accusing me of causing more diabetes. I'm sorry to say, but this statement isn't just valid for some types of diabetes, and not for others. NO diabetes is caused by any particular food choice.
The annoyance of Facebook's notification system: Facebook has just changed their system so much, that a simple event is now used to notify the heck out of others -- even if they haven't yet RSVP'ed for an event, and it thus made us look like 'spammers.' Not so Facebook savvy people kept attacking me, personally, for spamming them with 'the event' or for 'not taking them off the list,' or for revving up their cell phone notifications. We tried hard to educate folks on how to turn off their notifications, but there were just too many not-so-bright, self entitled, persons out there... whining about why we weren't doing these things for them. How these persons have managed to survive in Facebook's world is honestly beyond me. In future Diabetic Ice Cream events, we might hunt for a different method to keep track of 'likes' or 'rsvp's' so that such a massive amount of notification overload doesn't bring us down. We do suspect a large number of folks attended, but simply hit 'decline' to the invitation, just to avoid notification spam.
So, in essence, it kind of hurts a little bit when the social media tools that are at your disposal are backfiring on you, and when persons who are supposed to support you -- especially because their own personal dietary choices might be different or varied -- are not doing so. It divides us, and weakens our message of food independence. I mean, the only way we can be vegan, or raw vegan, or low carb, or anything else, is because we decided to become independent of the mandate that we had to live by a classic ADA style diet. And thank goodness we no longer live under the notions that we HAVE to eat by what a dietitian exactly says we have to eat, or by what the olden days used to believe -- avoid table sugar, only.
I am, in no way, an ADA diet advocate... but I will advocate for anyone who thinks that's a diet that gives them the self control, glucose wise, that they need. I will advocate for any regimen which they feel is balanced, isn't intrinsically dangerous or based on pseudoscience, and brings them euglycemia, ease of implementation, AND quality of life -- that's our goal!
I felt I needed to say a few things on the matter... before I blogged on anything else. The goal of the Diabetic Ice Cream Social has, and will always be... FOOD INDEPENDENCE.
I love, love, love the benefits the online social community can bring. Finding, and meeting others who are just going through similar enough experiences, is probably one of the most healing things a diabetic person can experience. There's so much REDEMPTION in just being with other diabetics, in THEIR shadow of hope and light... Let's face it, outsiders don't usually understand us... and doctors often don't understand us, either. Heck, sometimes we're lucky to even get an educated enough doctor... much less an understanding doctor. It's not uncommon for persons without diabetes to say some really insensitive, uneducated things... So it's also no surprise that one of the guides developed to help diabetics traverse the waters of outsider social stupidity is Accu-Check's guide for Diabetes Etiquette for People Without Diabetes.
That being said... the topic of this blog post might, or might not surprise you. I'm not here, this time, to talk about insensitive, non-diabetic folks... but about insensitivity within the DIABETIC community. As much as I love our community, and we bring light and awareness to many, many things, we really need some major help in these areas... Yes, it's true. We need to work on our sensitivity, and love for one another... because when we're pricks, we...
Cause people a lot of personal feelings about their diagnosis
Confuse people about the direction of their diabetes management
Make people feel marooned, and misunderstood... maybe even threatened
Ruin discussions that could be productive, and help ALL diabetics learn and grow
Ruin forums, and isolate folks from joining and participating
Do unto other diabetics... what we don't want non-diabetics doing to us!
Lately I've experienced firsthand, and witnessed a lot of this in our community... and quite frankly, it's time we started demanding of ourselves what we expect and demand of others without diabetes. So... I've decided to make a list of etiquette points... (dun DUN dun...)
for people WITH Diabetes.
Having diabetes is challenging, and embarrassing enough, at times... especially with the world's misconceptions and misconstrued ideas about who we are. On top of that, many diabetics do NOT get any education on the part of their medical team, false reassurances that they do not need to worry 'it's nothing,' and even LESS help with the paralyzing psychological aspects of denial, and coping with sudden and drastic life changes. Do NOT assume someone who is not making the right choices is just some slob. You are NOT in their shoes, and are only looking from the outside in.
Moms did NOT overfeed sugar to their babies; Type 2 Diabetics are not whiny, out of control slobs. It is NOT okay to point your finger at the world for recriminating you, and then turn around and point it at your fellow diabetic! Just because your neighbor Jim Bob, is a bitter, mean Type 1, does not make everyone else with Type 1 this way... and just because your aunt Betsy with Type 2 seems to pay no mind at all to her Diabetes does NOT mean everyone else doesn't! I can guarantee you that as far as there are stars in the skies, there are people of ALL characters and walks of life affected by EVERY disease. Not all Type 2s are heavy, or uncontrolled; not all Type 1s are thin, and controlled... Not all Type 2s are ignorant about their disease, and not all Type 1s are well versed on all their options. Just the other day I saw a Type 1 woman sharing with the world, on a forum, that Type 2s turn into Type 1s when they need to inject insulin... Ummm, yeah. I don't think so, lady.
People, we must educate ALL of us, and make assumptions about NONE of us.
I hope I don't need to explain too much just how wrong this is. I mean, after all... when you try to raise awareness about Diabetes, would you be okay with a non-diabetic person saying this to you? Your Diabetes type is NOT my problem? I don't need to learn anything about it? It doesn't affect ME, so it's not important?
Yeah... I didn't think so. Don't be a gratuitous jerk. You can't bring POSITIVE, momentum building, LIFE CHANGING... awareness... to your TYPE of Diabetes...by being the big jerk putting other people's type down. Stop the crap. It's a LOT more harmful for YOU and your loved ones, than you can fathom.
Listen to me... You have the right to control your destiny. You have the right to control your carbohydrate consumption, insulin to carb ratio, exercise regimen, or when to go on oral medications...
But you DO NOT... Listen carefully... You do NOT have the right to control, manage, and boss around another diabetic's personal management care, or their loved one's management care. You have the right to offer advised WHEN IT'S ASKED, but THAT'S where it ends. You have NO RIGHT to throw your weight around and bully other people over this. What works for you may not work for someone else, and it may ENDANGER their life. You have NO right or business doing this. So shut the F up and be supportive, even if you personally do NOT agree! There are many, many roads to get to Rome, and people do NOT need to pay a tollbooth of exclusivity to YOU. Got it?
While diabetes is NOT all the same, there are advantages, disadvantages, and dangers... to every form of diabetes, and every form of diabetes management. Please don't put down other people because you have rosy colored daydreams in your mind of what it's like on the other side of the fence. You can say any other diabetes is better, with an infinite supply of arguments: children getting diabetes is better, because they get used to it; adults getting diabetes is better because they can more maturely understand the implications, people without medications have it easier because they do not have awful side effects, people on insulin have it easier because they can eat anything and just bolus for it, etc, etc, etc. When you make every one of these statements, you DENY people the reality of their diabetes; their struggles, mental battles, and hardships.
People without medications often must exercise extreme willpower to control carbohydrate levels to such a degree, that they won't spike. MOST people can't even follow a crappy Jenny Craig diet. What's worse, people without medications don't have the most choices in bringing numbers down. I mean, if you're high at 3 am, would you want to go running at that hour?
People WITH medications are often subjected to horrible side effects: extreme gastric upset, diarrhea, potential lactic acidosis, kidney, liver, or heart damage, cancer, etc, etc. They can bring on some of the complications we work so hard to avoid, to begin with... Along with nausea, and hypoglycemia, as well, sometimes. Not only that, but some of these medications are ALSO injectables, so if you fear injections, it's really not much better than insulin.
People on insulin shouldn't also eat whatever they want; they must manage their food consumption just like anyone without diabetes. It's not a license to eat, and eat... And it's not like it's a walk in the park, either... There's hypoglycemia, and potential weight gain for many who are prone to weight gain, regardless of their type.
Children with Diabetes do NOT have it easier just because they got Diabetes as children... Diabetes puts a HUGE stress burden on the family, parents frequently fight or get divorced, or one parent gets incredibly burdened with the total care for their child. Not to mention, the bullying by other kids, etc., maturing at too young of an age, and NOT getting to enjoy childhood as normal children. Often a parent may push a child incredibly hard, for the sake of advocacy.
Adults with Diabetes have all manner of lifetime habits INGRAINED in them. I've gotten yelled at by roommates for not using the proper "tupperware" for putting food away, or by my husband by not putting things away exactly how he likes them... Are you kidding me? This is one of the hardest things to have to change AS AN ADULT. Life long habits that have nurtured us, and comforted us for DECADES. Also, it's pretty scary to have to face one's mortality, and it takes time to break away from denial... A young person may still have a supportive family; an adult may have limited friends, and persons they confide in.
Also... do you remember that one heartburn commercial? You know, the "Do you want heartburn now, or later?" How about I don't want ANY of it! It's all bad! Do not tell someone their Diabetes is NOT dangerous! Really? Do you want the danger now, or do you want it later? Is one really better than the other? Hmmm... Would you rather die as a child, leaving your family heartbroken, or would you rather die as an adult... with many traumatic complications... leaving your kids orphans? Let me think on that, for a while. NO... DIABETES IS ALL BAD. THERE IS NO MAGICAL DIABETES WHERE THE CARE BEARS COME AND GIVE YOU HUGS. GET OVER IT.
No juicing; no starving yourself on 600 calories a day; no raw dieting, no veganism, no NO carbing, no magical herb, plant, bird poop, or seed, from the Jababwey People, or whatever the hell, will EVER cure ANYONE'S Diabetes.
Do NOT go around quoting studies to people to make them feel bad... that they ought to be able to cure themselves, or at least try... This means you DO NOT have the right to go telling people they need go get islet cell transplantation, or gastric bypass procedures of any kind. These procedures, for as many studies that claim they are miracle working things, are also DANGEROUS, have LIMITED results, and are NOT a guaranteed cure for everyone. They are Russian Roulettes. They can, potentially, leave a person with even more problems than before... and are quite frankly, PERSONAL DECISIONS, AND NONE OF YOUR BUSINESS. A cure should do NO HARM. You have no RIGHT telling people these things will cure their Diabetes. I don't care HOW MANY careless, unscrupulous researches, or doctors, say that it is.
Furthermore, TIGHT CONTROL is NOT a cure! Reversing neuropathy, high numbers, dizziness, blurry vision, yeast infections... are all NOT signs of a cure. They are signs of TIGHT CONTROL. Go ahead and eat a big piece of pie, and test... I TRIPLE DOG DARE YOU.
When you behave like this, what kind of example are you setting for non-diabetics? How is the world supposed to treat us? What kind of example are you setting for your children?
Listen, don't get me wrong... There are a lot of people I dislike; I don't like their methods of doing things, or their ways of carrying on, and I may yell at them, sometimes... But I will NOT... WILL NOT... encourage violence toward other diabetics, in any way, shape or form, even as a joke. I will support EVERY DIABETIC, whether I like them or not... because this is NOT about the people I like. This is about a HORRIBLE disease NO ONE deserves to have. NO ONE. You will get upset at many people; you may even call them a name, or two, on your wall... But the minute you start encouraging other people to fantasize about 'bitch slapping' anyone... that's the minute you have become what's WRONG with the Diabetes community. There is NO SCENARIO in which this is even remotely OKAY.
Similarly, do NOT put down how other people raise awareness, and seek to boycott them. Everyone has the right to dream a diabetes cure how they see fit, and everyone has the right to be a leader. There is NO king and queen of the diabetes advocacy. Make helpful suggestions, and raise important points... even challenge things; but DO NOT piss on people's parades and tear down their house of cards. That is NOT okay. Diabetes Awareness Month is a SPECIAL time. Respect it.
Diabetes is complicated; there are no simplistic answers, and simplistic solutions. We all must do what it takes to care for ourselves, and be healthy... and that can't be done with guilt, or with shame; with uneducated, misinformed doctors, or with the media spitting out every bit of nonsense or poorly done research study there is. We are ALL diabetic, in risks, in symptoms, in need for effective care; we are ALL our brother's keeper.
Diabetes awareness is not just for OTHERS to be aware of YOUR Diabetes... it's also for YOU to be aware of other diabetics as well. Learn to stop myths in their tracks, and do not add to their buildup. For example, if someone says to you "Oh, is Type 1 Diabetes the one you can cure with diet and exercise?," don't reply with "No, you're confusing it with Type 2 Diabetes..." The right answer is "No, there are NO types of Diabetes right now that can be cured with diet and exercise; only some may be controlled that way." Similarly, if someone asks you if Type 1 Diabetes is the "bad kind of Diabetes," don't say "Yes, it's the worst." 1.) It makes people feel bad, okay? No one wants to be pitied, or to have people being taught to pity others with the condition. 2.) Like I said before, really? There's no magical Pooh bear in the Hundred Acre Wood Diabetes... 3.) Just let them know it's ALL very bad, just in different ways. There's no a single type of Diabetes I'd rather have...
Be inclusive, and make it easy for folks to JOIN in on your conversation, whether it's on twitter, or some event you're planning... Don't make things obscure, or cliquish. We can learn so MUCH from each other, if we just keep an open mind, and an open door. There are MANY issues that cross the borders of types... issues with making more glucose stable meals, issues with carb counting properly, issues with weight (sometimes), or developing insulin resistance (even in Type 1s)... Sometimes, we can learn from the courage, and every day management of a long time survivor of Type 1, the hope and unwavering faith of a Type 3, or from the life changing determination of a Type 2. Sometimes, all we need is to HUG each other, when the whole world just wants to turn its back.
At the end of the day, we are human beings who happened to get a disease they didn't want, and which has caused all kinds of havoc in our lives. Let's take a moment for turning around and just saying
THANK YOU!
Thank you for being there for me... Thank YOU for being 1 of 335 million who UNDERSTANDS Diabetes... and HAS MY BACK. Let's help and educate the other 334,999,999. Let's help save lives.
Now GO, AND DO THE BIG BLUE TEST! HELP SAVE OTHER DIABETICS, WORLDWIDE. WE ARE EACH OTHER'S ANGELS. DO NOT FORGET.
Don't just watch it, and preach it... but do it, and record your information HERE. Your advocacy will help other diabetics have life saving medications, and education.
