This might seem silly... I know. I know I don't have to try hard, or go far, to ask my readers to imagine for a moment being a person with diabetes. (Naw... You don't say!) ?

But still...! Imagine, for a moment that you're a person living with diabetes, and have lived with it for many, many years... Imagine it's been challenging. You've gone through many phases of burn out, and phases of challenge. It's been a deep struggle, for various reasons:

1. Managing this crap every day is a roller coaster, and well, it seldom likes to actually do what we expect it to do. Einstein once said that "doing the same thing over and over again and expecting different results" was the definition of insanity. I like to call it... Diabetes.
2. You have some white coat person always reminding you if you don't take care of yourself, you're going to die. And NOT in uncertain terms, either. 
1. You'll get retinopathy... 
2. You'll get nephropathy... 
3. You'll get neuropathy... 
4. All the opathies... 
5. You'll get your limbs amputated... 
6. You'll lose bladder function... 
7. You'll be impotent... 
8. You'll have congestive heart failure, or a stroke...
9. You'll go into DKA, or insulin shock...  
10. You'll DIE. 
3. You may not necessarily have many close friendships, in your immediate circle of acquaintances, that can actually understand you. 
4. You have some family members constantly reminding you of the things the white coat person was reminding you... 
5. You have friends, coworkers, and other relatives, wanting you to FORGET about what the white coats, and the other family members, keep reminding you, and then just go live life with them... "just live a little." (And it's always 'living' that's centered around food, or alcohol.)  
6. You have your own deep desires to want to just be NORMAL, or as close to normal as you can be... and "just live a little."
7. You've carried the heavy load of discipline, and care, however individualized your load might be, for a long, long time. You are very AWARE of how serious it is if you don't carry the load. 
8. You get tired...  You burn out. You drop the load.

Now... most of us understand this circle. We understand that it gets OLD carrying the load, and we get burnout. We stop... we go through the motions. Often, we even get eating disorders, etc. 

So we crusade long and hard for our folks, because, we don't want people to think we gave ourselves complications, when they happen. No one consciously says "I'm going to chug donuts! I want retinopathy!" -- Burnout IS a part of chronic illness. It is NOT a character flaw. It is not simply "people not doing their part," or not taking responsibility. It is simply... people being TIRED from taking on so much responsibility. 

By contrast, we may have well been doing 'our part,' and were just genetically predisposed to complications... But the world outside of us does not understand "genetically predisposed." The media doesn't tell ANYONE about "genetically predisposed" -- only about 'you can prevent and avoid complications, if you just take care of yourself.' Why? Because the media is not interested in shades of gray -- the media has a job, and that job is to gain viewership, and ratings. The only way you get viewership, readership, and ratings... is by generating controversy... And the only way you get controversy is by getting folks to think in the inflexible lanes of black and white. And when you scare people about the rising cost of diabetes (uncontrolled diabetes, mind you), and then show them articles about "My aunt Bonnie, who didn't take care of her diabetes, and was irresponsible, etc, etc..." people get MAD. Angry. Unsupportive. Unsympathetic. 

Does that make sense? I'm sure it does. 

Now, imagine a non-diabetic person... living their life as usual. They want to be normal, and keep living, just like anyone else... and as usual. They have the same family members, coworkers, and friends pressuring them to "just live a little." 

They go to their doctor, and hear:  

• "Meh, you could lose a couple of pounds, but you're fine."
• "You maaaaaay, or maaaaaaay not get diabetes down the long road... It's just not easy to say. But don't worry about it. You'll be fine. Just walk it off." 
• "Meh, you're blood sugar is a little high, but you're fine! There's no way you have any issues... Just walk it off..."
• "Nah, I don't think we need to test anything, you're fine... Just walk it off..." 

Now... If it is hard for us to get our minds wrapped around the realities and burdens of illness, when we HAVE illness... Imagine how hard it is for an illness-free person to get their minds wrapped around the POTENTIALS of illness, and some "boogieman" of illness, out there, somewhere, over the hill... that may come, or not come... but they can't really say for sure... It's just some hazy smoke and mirrors thing. Imagine being "genetically predisposed", but only if you trip! "Don't you ever TRIP!" (Of course, they don't ever mention the trip can also be almost anything, besides weight and diet...) 

Sure, hindsight is 20/20. I'd love to go back in a time machine, and slap the crap out of Liz, and tell her "hey, start carrying the load a little sooner!" (Not that it'd be of much help, with all my other health conditions, medications, and predispositions... They are, together, a much stronger trigger than lifestyle...) Some might say I was damned if I didn't, and damned if I did... But I'm not quite sure what I'd be avoiding, frankly... 

"Live sternly, as a diabetic, so that you don't become a diabetic." 

Seems a bit off putting... It might be hard to convince Liz. Especially if no one's serious about the boogieman... It's never around, and just some foggy illusion thing... And EVERYONE says you can get rid of it, if you do get it... (snark, snark) I mean, yeah, we should ALL do our best to be healthy, and everything... but Liz might want to enjoy a burden free life for a little longer -- at least, as long as she can. I mean, isn't that what we long for when we're burnt out? A bit of freedom? Choices? Splurging without going into some diabetic hell episode? Having a little more than a 1/2 cup of moderation?

Yeah, I thought so... What burnt out people want is not that different than what illness free people want. A little freedom, a little empathy, a little break, a little life.

So we should crusade long and hard for folks, because, people should not think we gave ourselves diseases, when they happen. Chronic illness is NOT easy to manage, but neither is it exactly so easy to avoid... No one consciously says "I'm going to chug donuts! I want diabetes!," and most people aren't binge eating disordered individuals... (And so what if some are... People have demons. People fight them as they can... or struggle, as they tire of their loads... Life is hard.) They are just people living... and illness IS a part of living. Illness doesn't really care if you gave it to yourself, or not. It is NOT a character flaw. It just is... It is simply... people going through the motions of LIVING... 

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"Well, my husband is a board certified endocrinologist, and he told me that whenever a Type 2 patient is 'good,' and gets their numbers 'normalized,' that he removes the Type 2 Diabetes diagnosis, and changes it to a 'Metabolic Syndrome' diagnosis, instead, to help them out." -- Misinformed Mrs. Know-It-All.

The woman was very angry at me. How dare I suggest Type 2 Diabetes has no cure. And furthermore, I could go get a gastric bypass surgery, if I wanted. That, for certain, was also a cure. This, of course, was followed by a few "You people will never be like us; you need to stop comparing yourselves to us... You keep trying to act like we are the same, or have it worse than us, or that your disease is just as bad as ours" type of comments. I can't say that I blame her entirely for her misinformed, self righteous attitude. (Okay, I know she was being kind of a bitch. I'm just trying to be nice, here.)

This is the every day bread of Type 2 Diabetes awareness. Raising Type 2 Diabetes awareness is not easy. In fact, it's one of the most painful things I've ever had to do in my life. My husband certainly doesn't understand it, sees a redundant theme in it, and wonders why I don't just get out of it... since it's obvious I can't change the world. I've gone to bed crying, on more than a few nights.

The comment above, is of course, ridiculous. If there is a board certified endocrinologist out there, doing this, he needs to have his license revoked. Simple as that. He is doing NO ONE any favors. He is hurting his patients a lot more than he knows. I understand that insurance companies love judging us -- hey why not, the media has done a great job of misinforming the world, and insurance companies get their news just like the rest of us, and want to use that to safeguard their old, mighty dollar -- but the value of a 'small defense' against an insurance company does NOT outweigh the psychological harm and denial you feed into a person by acting like their diagnosis doesn't exist. Would these people dream of telling someone who had AIDS "If you're good, and your labs come back good, I'll change your diagnosis to HIV positive, instead?" Yeah, I don't think so! (It's not entirely a perfect analogy, but you get the idea...)

But people don't GET the permanence of Type 2 Diabetes. What's worse is that, while we preach day and night that this is an epidemic of epic proportions, our medical establishment does not act like it! (Oh, lots of people are acting like it, don't get me wrong... but it's, mostly, the people who want to scam us, and take advantage of us...) If this is such a serious threat, why isn't the American Medical Association, and the American Association of Clinical Endocrinologists, making it a priority to get doctors educated, and prepared, for diagnosing, and empowering patients? Why are they not working hard to give patients the weapons to fight back, and effectively not feel themselves the hopeless victims of this disease? (I know someone out there will claim that they are... but the proof, or lack of proof, is in the pudding, folks.)

• Patients are out there, going undiagnosed, not because they don't regularly see a doctor (though some, undeniably don't...), but because doctors don't know how to recognize the signs of diabetes, or are UNWILLING to mark down a "diabetes diagnosis" in a patient record, thanks to insurance company scheming. More and more Type 2 Diabetes patients are being diagnosed by other medical professionals, such as gynecologists, urologists, dentists, and eye doctors. Often, a patient even gets misdiagnosed based on ridiculously old knowledge, like assuming that an adult could not be a Type 1 Diabetic, instead, leaving the patient vulnerable to Diabetic Ketoacidosis, and Diabetic Coma.  
• Most doctors, especially Primary Care Physicians (or Family Doctors), get a MINIMAL amount of diabetes education in medical school, and NO extended diabetes education throughout their careers. Diabetes information, care, and knowledge is growing about as fast as technological advances are... why should doctors remain in the dark, if we, as patients, can't afford to do so? Some doctors are going by on 20, and 30 years of OLD diabetes education! As a consequence, when a diabetic patient gets diagnosed, thanks to this lack of knowledge and insurance company scheming, patients get denied access to specialists, denied access to certified diabetes educators, denied access to dietitians, denied access to insulin, etc. Doctors, ROUTINELY, give NO information or direction to a newly diagnosed Type 2 Diabetes patient, leaving them vulnerable to whatever might be out there, on the internet. There is something vastly wrong with an insurance company that denies access to a dietitian, or certified diabetes educator, but is happy to approve gastric bypass surgery. In other scenarios, doctors give patients extreme misinformation, such as "STOP eating ALL fruit because they are high in carbs." Ummm, hello, not all fruit is made the same... We need to learn to MANAGE food, not put the fear of God in people.   
• The medical establishment is allowing itself to be ruled by the treatment guidelines of the American Diabetes Association -- an Association with clear conflicts of interest, per a recent study done by the Mount Sinai School of Medicine, and which has been SLOW AS MOLASSES in embracing the future of diabetes tight control, and management. What's worse, they have GREATLY contributed to diagnoses getting delayed and delayed. This is WRONG and unacceptable. Doctors and Endocrinologists need to be educating the ADA, and not the other way around! 
• Instead, more and more "doctors" and "medical professionals" are taking advantage of the serious need for diabetes patient education, as a door to write books, push supplements, spread their own pseudoscience, and MAKE MONEY. 

Don't get me wrong, here. I am not anti-doctor... and I understand that doctors are humans, too, who can make character and judgement mistakes. There are some AMAZING, well educated, empowered doctors out there, working hard to help empower diabetic patients, and help out in the online diabetic communities... But the overall lack of education, and standards, in general, for our medical professionals is wrecking havoc in our lives, as patients, and it's wrecking havoc in our ability to garner empathy, build awareness, and motivate outsiders to help donate their time and money in the hopes of finding a cure. Who donates to something they think already has a cure? 

Dear doctors, you have MUDDLED the language of Diabetes, and made it a messy affair. Every time you get on TV, write a self serving book, misinform a patient in your office, you MAKE IT HARD for us to live, control, master, and grow, with this disease. How can we, as patients and advocates, have power behind our voices, if you tell lies to people with an M.D. next to your name? Who is going to believe US over you? 

• STOP making up statistics to sell books! No, 50% of Americans don't have diabetes... 33.8% of Americans are obese, but only 8.3% of Americans have diabetes, and that number INCLUDES all types of diabetics, including the undiagnosed. Anyone who claims these things NEVER quotes any real studies, double blinded studies, studies published in any legitimate journal of medicine, of any kind. They make up catchy terms to feed on people's biases, and fears for self serving purposes. Stop getting on Dr. Oz to sell LIES. Broccoli is NOT going to cure anyone's Diabetes. (I'm looking at you, Dr. Hyman.)  
•  STOP telling people gastric bypass will cure their Diabetes. It will most certainly NOT. And what pisses me off the most, is many of you have gotten on TV, and the news, and told everyone that it is, and that it's 100%. Now I can't frigging walk anywhere without some moron asking me why don't I just get bypass, or some other form of that. Well... don't mind if after being called misinformed, and uneducated, by people the likes of Misinformed Mrs. Know-It-All, above... that I get angry when articles like this hit the news, FINALLY admitting the truth... No I am not in crazy denial! It is NOT a frigging cure, or a guarantee of anything! Remission is NOT a cure, it is tight control. And this surgery is a Russian roulette! And, hello, I can improve my OWN care without a surgery, and *I have*, thank you very much. Someone should staple your mouth, instead. :S 
• STOP throwing terms like "reverse", "remission," and "cure" around, in exchange for tight control. Even a Type 1 Diabetic can achieve tight control, and reverse complications, and that does not mean they are cured. Type 2 Diabetes is a progressive illness that requires vigilance, and ongoing monitoring, and with time, those medication free moments will be just a thing of the past, and we will need oral medications, and insulin, to keep healthy, and in tight control... Most full blown Type 2 Diabetics will eventually need insulin, in their lifetime. We may be able to prevent complications, or even slow or 'reverse' the progress of some of them, but there is NO reversing or curing Type 2 Diabetes. Stop bullshitting people. We are big boys, and girls. We can deal with the truth.
• STOP telling people that losing weight will make their diabetes go away! Stop telling patients that they are cured, while they are in your office! These are harmful lies, for all the reasons I mentioned above. Weight loss does NOT remove Type 2 Diabetes. It only helps MANAGE it. Type 2 Diabetes has NO CURE. 
• STOP telling people they can prevent Type 2 Diabetes. NO ONE can prevent anything. This creates feelings of insecurity, self blame, and inadequacy when a person gets diagnosed with diabetes despite having done everything in their power to change their odds. Why not simply talk to people about REDUCING THE RISK of getting Type 2 Diabetes? Isn't that, instead, a little more realistic? Diabetes is NOT a zero-sum game. Everything has risks. Nothing is black and white. 
• STOP equating diabetes with obesity. I GET IT. I am not a moron. I know that there is a very STRONG link with diabetes and obesity. It is a risk factor. Obesity, however, does not mean diabetes.  There is NO SUCH disease as "Diabesity." Obesity is it's own disease with its own complications, and Type 2 Diabetes is an autoimmune and metabolic disease. There is no known cause for Type 2 Diabetes. Why not all obese people develop an autoimmune response that leads them to Type 2 Diabetes? No one knows. And why are not all Type 2 Diabetics overweight? (Sure, some are misdiagnosed, but many are not...) The fact is, no one knows. There is also a very strong link between diabetes and pollution and pesticides, BPAs, drugs (such as statins, beta blockers, antidepressants, antipsychotics, steroids, etc.), other illnesses (like Polycystic Ovarian Syndrome), surgeries, drinking, smoking, etc. Why can't we discuss ALL of those risks? Why can't we be realistic about Type 2 Diabetes? Why can't we speak to people with the entire truth? There has been a 400% increase in antidepressant use by Americans.  Don't you think THAT has had more than a little hand in raising the Type 2 Diabetes incidence? 

And another thing... if it's so easy for you to tell a patient with Polycystic Ovarian Syndrome that it would be helpful in controlling their disease to "eat a balanced diet low in carbohydrates," WHY IS THIS SO FRIGGING HARD TO TELL TO A DIABETIC PATIENT, AS WELL????? (Oh, that's right... it's because pills to treat PCOS don't cost an ARM AND A LEG, and don't make you any kickbacks.) It's not that that is all that is required for better health, but come on, throws us a bone! People are out there avoiding sugar, and all fat, thinking this is what made them diabetic, and thinking what we eat in itself gives us diabetes! It is NOT. 

Doctors, this may not be entirely your mess... But you sure have lathered yourselves with GUSTO with the manure of laziness, and greed. I hold you PERSONALLY accountable for the state of our nation's health when 2050 rolls around. Get some guts, and fight on our behalf.  

 

 

 

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The room is dark... though a few sprays of light come in through the windows; beams from the outdoor lamp posts invading my thoughts. The evening's navy watercolors wash the walls, and windows... and the sounds that would normally lull me to sleep, now keep me awake. The man's heavy breathing, the cat's snoring, the whistling of the wind through the glass panes, the neighbors upstairs finishing up whatever toiletry rituals.

The bed feels lumpy, unusually so, and I toss and turn. I toss on my left side, and I feel the burn shoot through my esophagus, damned acid reflux that never plays nice. I have to, somehow, find a way to straighten my arms, uncurl the wrists, unclutch the comforter. I never liked my thoughts, much, at this hour... Much like the acid reflux, they just never play nice. Irrational foreign invaders, like quixotic windmills, in my mind. I am scared, I admit. I am tired, and I'm scared.

I haven't exactly been taking the greatest care of myself, over the last month or so. Why can't I just find the will, the strength, and just keep going? Be perfect all the time? Why can't I just pick up, and do what mostly no other person (without a chronic illness) really does (but claims they do), and save my life? I see them eating crap all the time -- those skinny goody two shoes... I see them there. Living the chronic free life. Chronic. You'd think I was talking about pot. Save my life. I shouldn't have eaten so many carbs. I think of my dad. I think of kidneys. Gosh, I think I can feel my kidneys. Proteins, flushing, overpowering, disempowering. Would I even be able to know if there was something wrong with my kidneys? No. Not really. Not without insurance... though perhaps, though, through the Free Clinic.

But not my ovaries. No one cares about my ovaries. Ovaries are "luxuries." I think about what state mine must be in. My thoughts race, and travel, and warp, and twist... Planned Parenthood can't do anything about my ovaries... I think about women losing ovaries to cysts. Why the hell me? What the hell was so special about ME, in my family, that I had to be the one born with the woman-changing-into-a-man-disease. THIS IS SHIT. I think about that stupid woman from an old job... that woman who must've weighed about 400 lbs, yet she had no disease. No disease, but the obesity, of course. I don't blame her, one bit... I am jealous, I have to admit... But she'd sit there, and ask me dumb things. She'd ask me "Why is your scalp all shiny under the lights? It's so shiny!," and she'd giggle... Sigh... how the hell do you tell someone "Bitch, I am losing my hair, can't you get some manners, tact, and a sense of self??" I don't want to lose my hair... I don't. I am NOT my hair. Hair. I have waaaaaay too much facial hair. Goddamned PCOS. I am tired of plucking away the hair... I can't handle waxing, can't afford electrolysis, much less laser hair removal... So pluck, pluck, I must... What to do about all this crappy hair??? Every day... I am more and more a shadow of who I used to be... a woman with no hair on her head, and all the hair on her face. I constantly forget to take my medicine. Stupid Hypothyroidism, stupid PCOS. I. should. not. have. eaten. so. many. carbs.

I must toss onto my right side. I wonder if I'm losing my mind; a person without a proper job... ends up losing their mind. My back hurts, my breathing is hard. Anxiety builds, and I think about my current job. One to two days a week... Unloading trucks. I start to cry. I don't want a job, I tell myself. Employers are mean people, they persecute you, people want to run you over for their own fortune. Still, I must get a better job, another job, some kind of job... I wonder if I can have a job just ranting and raving craziness, like I do now... I think not. Those are reserved for people with more glamorous, yet crappier diseases. Diseases where people aren't to blame for their crap. There are crappier diseases? I don't know... I think about the new yogurt place, downtown. All the same yogurt, all a different flavor, all the same stuff. All the same crap.

Stuff. Too much overwhelming stuff. If I fall asleep, for just long enough, I can forget about some of this stuff. I can put depression back inside that box, and busy myself with life... but just for long enough.

I should not. have eaten. SO MANY CARBS.

Carbs, by basalt

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As diabetes advocates, we spend an awful lot of time writing about our challenges, our frustrations, and the misinformation that is so rampant out there in the media, internet, and medical professions.

It is with great JOY that I write my first post of the year, giving a STANDING OVATION, and a very much heartfelt thanks, to the Mary Greeley Medical Center, in Ames, Iowa, (just a few blocks from where I live) for taking the time to create an innovate way of FIGHTING misconceptions and stereotypes among medical professionals, and giving them an idea of what it's like to live with this crappy ass disease, even if it's just for one day. While some of us may not be on insulin, diabetes still demands many changes, vigilance, and eternal food obsessive thoughts... (What to eat, how many carbs does that have, what's in that dish, I am too high right now to eat, I need to stop right now, and eat... etc, etc.)

It is, for all of us, so very "damned inconvenient," as was put by Dr. Timothy Leeds, an obstetrician that participated in this exercise.

Basically, June Heiden, a registered nurse and certified diabetic educator, came up with this plan... to assign "Diabetes for a day" to several medical professionals, and to have to go through the inconvenience of stopping their day, and everything they are doing, to treat lows, highs, focus on meals, and count carbs... and everything that goes along with it... well, except the actual feeling of the lows and highs (cus well, they don't actually have diabetes)... To help create a 10 minute educational video for medical staff, and the public.

I am, to say the least, more than a little impressed with this idea. I've always daydreamed of my medical staff knowing what it's like to live this obsessive/compulsive roller coaster for just one day.

While I am sure there is much, much to be done in our community to IMPROVE how we approach persons with Diabetes, of all types... I have to say KUDOS, MGMC. You've done a job WELL DONE.

Please, take a moment... to leave a comment, either on our town's feature story, or write a letter to the MGMC staff THANKING them for this creative enterprise.

As reported by the Ames Tribue: "A day with diabetes: Medical center films education video".

And here it is...  "24 Hours: A Day With Diabetes"

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I love my Christmas tree... I light it. I enjoy it's silent cheer; it's proud glow. Perhaps, a memory of a 'perfect' childhood, at least, in my own imagination. The room is messy, but the tree makes it come to life. It brings a certain peace to my heart. It makes everything... 'perfect.' I probably won't take it down for a few more weeks.

Peace is a little hard to come by, these days... The worries of adulthood, and the insecurities of employment and finances, really take their toll... on one's joy, one's dreams, one's relationships, one's family, you name it. Still, I sit, and wonder... at the 'magic' of it all. When folks sort of stop paying attention to the "mess" in their lives, for a moment, and just stop for some peace.  

And peace, hope, growth, and prosperity is what I wish for all of you, this holiday season. I wish all of you to be BLESSED in one way, or another... And to make NO resolutions. 

NO RESOLUTIONS. Instead, look back upon the year, with bittersweetness; say goodbye to friendships that are parted, and welcome new ones... Say thanks for all the hardships, lessons, and opportunities life has awarded you, and for all the mistakes you have made. Especially, for all the mistakes you have made. Cheer on the challenge a new year will present, and be hopeful for what's to come.  

Be hopeful... 

• That friends and family will embrace, love, and support their fellow diabetics through this hard and challenging journey, without recrimination, and judgment, but with education, and a listening ear. 
• That diabetic patients receive the respect and dignity every person with a chronic illness DESERVES to be afforded, without gimmicks, media misinformation, doctors selling their profession for fame and a quick buck, and discrimination. 
• That government, and employers, strive to learn, educate themselves, and accommodate diabetics and their needs, and realize that we are just as capable, and just as willing to do a good, and proper job. That we can be just as productive, and careful good citizens, as anyone else. 
• That doctors will EDUCATE themselves, and not make insensitive comments or unfair comparisons,  uneducated assessments, guilt trip patients with the blame game, give uneducated guidelines, and endanger patients lives. That they become aware of the HUMAN EQUATION, and grow some bedside manners. 
• That patients presenting diabetic symptoms will NOT be ignored until it's dangerously late, and they have developed irreversible complications.
• That patients will be properly educated at diagnosis time about their disease, and ALL their treatment options, and not left wondering in the dark about what to do, or how to make adjustments, and NOT DENIED access to proper specialists, such as endocrinologists, certified diabetes educators, or dietitians, but be left with only limited options such gastric bypass for those who are overweight... either because of professional ego, or because of insurance restrictions.
• That patients will not be diagnosed based on biases -- but that every person out there presenting diabetic symptoms be given COMPLETE testing to determine not just whether they have diabetes, but where their insulin production stands, and their type of diabetes, REGARDLESS of their age, or their weight, so that they can receive the PROPER CARE they need to manage their condition, and educate themselves without much danger, second guessing, grief, and confusion.
• That patients will receive proper access to medicines, and NOT DENIED access to insulin, needles, or test strips. That patients be allowed to test as often as THEY deem necessary. It is THEIR right to be vigilant, and it is THEIR right to stay alive. Test strips might seem expensive, but they are not, in comparison to the costs of the complications of poorly controlled blood glucose levels.
• That patients will receive proper access to any care they need, and any tools to management they need, including pumps and CGMs, and diabetes alert dogs, without exorbitant expenses, or insurance games; in fact, that insurance companies will one day not be necessary.
• That diabetic research organizations devote enough resources and work into finding a true CURE, because we are not a lost cause once we have gotten diabetes... We are just as important as those they hope to help avoid the risk of getting diabetes. ALL of us deserve a TRUE cure. Not gimmicks. 
• That together, we can tackle the challenges we face because of our many health concerns, and realize that we are all the same... Just folks wanting to be acknowledged, and heard; folks wanting to be UNDERSTOOD. 

This is what I long for, hope for, and work for... in the year 2012... It is my Diabetic Manifesto. If we work together, we can slowly turn the tide... Won't you join me? 

(I am sure glad that, in my culture, the holidays last a little longer... At least for now, I'll have a little more hope, and a little less mess.) 

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Dear Friend,

I heard you were recently diagnosed with Type 2 Diabetes, and that you may have some mixed emotions right now (sadness, shock, anger, guilt, shame, denial, grief, fear, just to name a few...), and I just wanted to let you to know that it's OKAY to feel the way you do. Life, invariably, takes us through periods of transition, of growth, of personal reflections in which we must face, not just who we are, but our own mortality as well. This is a normal part of life: it's called the human equation. It can be frightening, to say the least... but you are NOT alone. No matter how "perfect" some of us humans may seem, we ALL go through this. Life plays no favorites.

No doubt you are already searching the internet left and right for all manner of information on how to best care for your diabetes, and may even have already developed a plan of action. If you are like most Type 2 patients, your doctor probably put you on a course of Glucophage/Metformin, without many other indications, and just sent you on your way. This is very typical. At least, here in America, most doctors really don't sit down with patients to find and discover what their needs are, what their BEST tools for diabetes management should be, what their individualized blood glucose goals should be, nor what their OVERALL TREATMENT GOAL should be.

I want to commend you for taking the initiative to take the upper hand in managing your condition. It takes guts to face a chronic health condition, and take a long hard look at ourselves, and what may need changing. With that in mind, I want to warn you... that while there are many voices of reason out here, in the internet, and many well meaning voices, there are also many confusing messages. Now, I'm not trying to say here, in any way, that you shouldn't do your own homework... oh, no! We would be in a hard place, as Type 2 Diabetics, without the internet. PLEASE DO YOUR HOMEWORK.

What I am trying to do, though, is put it all into a little perspective for you.  

You see, the voices of the internet are many... 

Some are naive, uneducated, patients... optimistic, and with their hopes misplaced. 

Some are well intentioned, go-getters, who may see the world as one of "black and white" solutions.

Some are from the "ignorance is bliss" bunch. They never, ever, question their doctor, or dietitian, ever.

Some are trying to sell you something -- a book, a diet, a supplement, an exercise regimen or way of life, etc.

Some are the naive, uneducated, misguided, optimistic patients, mentioned above, who have fallen for the ones who were trying to sell you something... 

Some are patients, who like you or I, started with little... and have now lived with this disease for many, many years. They have seen the good, the bad, the ugly, the unrealistic and unhelpful, and the scams... They are healthy, they live and thrive, WITH diabetes, and they are doing just fine. (Latch on to these people.) 

...and while they all have different agendas, they are ALL trying to tell you exactly what your doctor should have sat down, and told you: 

• What your BEST tools for diabetes management should be;
• What your individualized blood glucose goal should be; and
• What your overall TREATMENT GOAL should be.

Now, we are ALL different... And I cannot, and will NOT pretend to tell you what your BEST tools should be, or what your individualized blood glucose goals should be. And NO ONE should, either. Your health is different than mine. You may have more challenging health hurdles to clear than I have, or you may not. And you should DEMAND to discuss this with your doctor, at length, based on your own research. As they say, your diabetic mile may vary. Your shoes, your trail, your journey. 

There is one thing, though... that I can UNEQUIVOCALLY tell you: What your treatment goal should be. 

Let's start by what your treatment goal is definitely NOT: 

• Getting off of oral medications
• Getting off of insulin or avoiding it
• Losing weight
• "Reversing" diabetes 

The first three are POTENTIAL symptoms of what your unequivocal, overall goal should be. The last one is a  fallacy, and a buzz word. One may potentially "reverse" some symptoms and complications of diabetes, but not the diabetes itself.  People claim there's much debate on this, but there really isn't... Just watch as this M.D. sidesteps the entire term, in this Q&A column: http://health.msn.com/health-topics/diabetes/taming-diabetes.  But I digress... 

We focus far too much on the pretending we can cure diabetes, especially by avoiding the "evils" of oral medications, and the "evils" of insulin, or the "evils of being overweight," to understand that this one goal far outweighs them all... 

That goal is GOOD GLUCOSE CONTROL.  

In your war on diabetes, THIS IS the goal. IT. IS. THE. GOAL. 

Do not lose perspective. Do not feel discouraged, and give up, if you have weight to lose, and you haven't lost all of it... 

Do not avoid seeking help, if you need it. While many medications have their downsides, and side effects, they also have some upsides, and they are not a shame or a failure, when needed. If after changing your lifestyle, diet, fitness regimen, eaten nothing but chia seeds for two weeks, ran marathons, etc, etc... you find that you still have blood glucose control issues... it's OKAY. Explore your treatment options with your doctor.

STOP FIGHTING THE WRONG BATTLE. 

We age, life passes by... This disease is progressive.  Should the heart patient feel bad for taking lithium? Should the cancer patient feel shame for needing chemotherapy? NO. Of course not! 

The enemy here is the heart disease, the cancer, the HIGH BLOOD SUGAR. Do not let yourself stay in a state of danger because you were pushing for the WRONG goals... 

 Remember... Your shoes, your trail, your journey. Your diabetic mile may vary... But your number one, overall, UNEQUIVOCAL, treatment goal... will NOT. 

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The things you say, and do, have an effect on people. This one should be a "no brainer," right?

Well, not quite.

At least... not quite for folks who see you as "something to crusade against." A faceless mass, or a faceless evil, or villain, that it's okay to heckle, taunt, or verbally assault for the "benefit of humanity, at large," whatever that might be. And that, I'm afraid, is what the internet has done to Type 2 Diabetes and obesity. Coupled with anonymity, the internet has sort of given a voice to the uneducated, the predators and snake oil pushing charlatans, the frustrated, and yes, even the downright abusive bullies among us.

Quite honestly, it is NOT easy for me to be active online when people left and right are trying to sell me books, supplements, Chinese herbs, or whatever the latest craze is to "100% cure" my Diabetes. (Diabetes, of course, has no cure... and in my opinion, this is dangerous and should be against the law. But alas, the FDA doesn't give a rat's ass.) But it's even more difficult when you THINK you have found a "haven" from the mean-spiritedness of the world in a Diabetes page, group, forum, or social community.

As a newly diagnosed person... you may think others are kindred spirits. I am sorry to say, many times they are not... and we need to learn to be emotionally mature, and confident within ourselves, to be able to handle these situations (which, of course, we are not, when we are newly diagnosed.)

Just yesterday, a well known diabetes site asked the question "Medicare announces that it will cover weight-loss counseling for the obese, but critics argue it will make little difference. Who's right?"

I'd love to say polite debate ensued... But it was mostly a "blame the fat, lazy person" tirade.

"Do we really think "counseling" will help the obese? Really? If you're obese, it's due to a lack of discpline and complete laziness. NO EXCEPTIONS TO THIS RULE!!!" 

"I don't believe any type of counseling will work for people over weight. You either truly want to loose weight or you don't, and if banding your stomach doesn't work then counseling isn't either." 

"Can you honestly tell me that people don't know eating McDonald's every day isn't a good idea?!" 

" Weight loss is really self control & few people really have it..."

People are raging at many things; things they don't understand, or think they understand. It really reminds me of the Cold War, and the "Red Scare." We just have these simplistic "notions" of what's the enemy, and what's "right," and what the tv tells us is wrong, and bad... and we run with them. We think, "it's okay, these are 'faceless people' on the internet... We can hate them. We can abuse them." It's easy. Doing these things doesn't entail you to actually WORK at being a HUMAN BEING; to actually be an ADULT, and use your empathy skills. 

Doing these things keeps you from seeing people as mothers, fathers, brothers, sisters, spouses, other people's loved ones, other people's children. 

And worse yet, we may think "these people have taken from me, and my loved one...," and we fail to see how the system has failed EVERYONE, and not just us. Instead, what we are doing is PROJECTING our own bitterness at others. We have developed Diabetic Penis Envy. 

I am sorry.  

I have to call it something funny. I have to call it something funny, or else I'll cry.  

I'll cry when I see fellow diabetics verbally assaulting other diabetics because they are HUMAN and STRUGGLING, and they are brave enough to share their broken pieces with the world. I'll cry when I see mothers attacking other mothers over how they care for their child... I'll cry when I see someone putting down another person's personal loss "because they had it coming to them... they were Type 2." 

I'll cry over your bitterness. I'll cry because I know this disease has blinded you. It has blinded your heart. You either found a little private island in the middle of the sea, and wonder why no one else has gotten there, OR you are exiled in the desert, with nothing but mirages in sight, and no respite. You either judge for attention, or want to be the victim, for attention.

My heart goes out to you because I know it's not about me. No matter how much you try to make it be about me, or about any other type of diabetic there is... it's not. It's not a war of types. It's about YOU. It's a war WITH YOU. And it shows when you write jokes putting down folks, when you character assassinate people who may be struggling with their control, or their weight, or their kids, or when you try to make it sound like your type or your way is the paradigm of good health. It's not. We all need to work on something. 

If we want to help unity in our community... if we want to help diabetics out of the hole of shame and fear they may have... And help them know it's OKAY to be them... then we need to help GUIDE and SHEPHERD them... I would like to ASK two things: 

• I would like for communities to develop a ZERO tolerance toward judgmentalism, abuse, abusive language, and bullying of anyone, but especially obese persons and persons with Type 2 Diabetes, including warning folks, removing their comments, posting discussions redirecting attitudes and educating, and up to, and including banning; AND
• I'd like especially abusive folks to be directed to counseling. We NEED to be reminded that we need help. If it's 2011, and we are adults, and we are still bullying other adults, especially ones with a chronic illness, we OWE it to that person to let them know they NEED COUNSELING. And their bullying behaviors will NOT be tolerated. It is, quite frankly, DISGUSTING. 

The First Amendment is for the GOVERNMENT to not invade our freedom of speech; it is not for a community to allow people to bully other people. EVER. Directly or indirectly. Until this is fixed, you will see many people join... and then fall off, and not participate. It gets old. 

Don't just call for change in our communities... Help ENFORCE the change; BE the change.

And yes, friend... if you read this... and you find yourself a little bit bitter... It's okay. I'm often, a little bit bitter too. 

I add this sort of cruel, and yet "funny," video... as an apt comparison in 'reactions' to my "gift" of Diabetes. 

Oh... and by the way... I forgive you. 

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