September 29th, 1985.

I remember I was with my dad, out in the country. My dad was a real estate appraiser, and often would go appraise homes or farms 2-3 hours away, deep in the Puerto Rican country side. I loved it. I put on my 'Tinkerbell' brand make up, and dressed up... and dad would let me take pictures of the properties. You got to see a different way life; farm animals up close, and the people were always so kind. Sometimes they'd pay you in fruit, giant bunches of plantains or bananas, or even legumes. Sometimes in animals, like rabbits.  (I came by a pet rabbit that I adored, this way.)

I don't remember the town we had gone to (it might have been Mayag�ez), but I remember it was raining soooo much, and we had to cross the A�asco river bridge. You could see the river was really right up to the edge, and it was quite scary. Dad took a risk that day, and crossed anyway. We made it home, but many other people did not... Just a few moments after we crossed that bridge, the river took the bridge, cars and all. 

To say we had a tropical wave is to put it mildly. We always have tropical waves. No one bats an eye. Some rain, no big deal. Except... I have never seen another tropical wave like this, that wasn't - well -- a hurricane. No one was prepared. The wave didn't have a defined center, so it was never classified as anything stronger, and no one issued any warnings, or was seriously worried.

But on September 29th, the rain began... and it didn't let up. We had about 32 inches of rain in ONE day. By comparison, Oregon gets 37 inches of rain in a year, and Hawaii about 23.

The night was even more horrific. We had no power for a long time, and would listen to reports from a battery operated radio.

There were many awful stories, but (in my mind) the most traumatic story came from a man who was travelling late at night, when suddenly and by grace, he noticed the bridge was out. (Many bridges fell that night, and I can't remember which one this was, but I do remember it was a very tall bridge with a river raging below. The river had taken the bridge.) He stopped his truck by the side of the road, and tried... as much as he could, to flag and stop other drivers and keep them from plunging into the cold, raging waters. But he failed. People thought he was a lunatic, a mugger... a crazy person. One by one, he saw many cars plunging into the depths... No one cared to listen. They were sure of themselves, and their judgments of the man.

The scene... played out in my mind over and over. It gave me many nightmares. (I was only 8...) The chance were I, too, could have died... also played in my mind. It was an unnecessary risk. A foolish risk.

This is how I sometimes feel, when I work with people with diabetes who are not exactly knowledgeable, or in control of their care. I feel like a desperate person, trying to flag down helpless people... unaware they're an inch from losing their lives, because of their own pride. 

• People with constant out of control numbers, thinking it's 'no big deal,' because they aren't 'as bad' as their previous numbers... or because they don't feel bad.
• People not getting on much needed insulin, afraid of myths, and stereotypes, or for crying out loud, of a needle, and poking themselves. (I'd much rather be afraid of the horrible consequences of uncontrolled diabetes than some needle.) 
• People who want to obey everything said to them by medical professionals, hook, line, and sinker... without much thought, or research; who stay on dangerous regimens, out of control numbers, and ineffective medications, or diets, because they're too afraid to say something, or seek a second opinion. 
• People being lead away by 'miracle cure' nut jobs, or crazy fad diets, and supplements. 
• People who won't check their blood glucose numbers, because their doctors said they didn't need to! 
• People who just don't wake up... no matter how much you share with them, or try to guide them. 
• People lacking in courage... to truly admit to themselves the seriousness of this condition. (Out of sight, is out of mind, I guess...)  

I know I can't police people, or change their minds... or tell them how to manage their diabetes, or how to tell when a medical professional is less than professional, or bad... or that they ought to seek more in-depth information about their condition. I know. But often, in groups, and forums... it sometimes feels like someone wants to start a conversation by asking you your opinion, and then not letting you have an opinion; telling you you're wrong... or just brushing you off. Or by bragging of their careless life. (Yes, there are occasional folks who brag about their out of control lifestyles... and not just occasional escapades, mind you, and bring down the whole mood of everyone around them.) 

As someone who has seen what it's like to die from ALL the most horrific complications of diabetes, I can't help but feel like that man, on the side of the road. I just do. Denial is a powerful thing... and I wish I could slap people right out of it. Uncontrolled diabetes (especially type 2 diabetes) is like a thief in the night; you don't hear it or see it coming... and one day, you've just been robbed blind. It makes some folks overconfident in themselves, and their lack of care. 

And these people... who want help, but don't want help. That is the MOST frustrating type of diabetic. And none of us can help them, medical degree or not, until they want to be the pilot in their care, and not the silent co-pilot. A Stepford Diabetic.  

» Read More...

The headline declares: "Curing diabetes via surgery, without weight loss". It's a bold statement. It's enough to make one stop, and read. I admit I did just that.

Every week, it seems, we are bombarded with a new article declaring the magical, curative qualities of gastric bypass surgery. These articles make it seem like gastric bypass is the simplest, most sensible way of managing diabetes -- and gosh darn it -- everyone ought to pursue it so we can put a stop to this overwhelming epidemic that's going to just take over America, and murder us all. (Please note I am being sarcastic here.)

I admit I don't have all the answers -- if I did, I'd have long ago found a cure for all of us, and retired to my white castle atop a hill, facing the ocean. But what I can tell you is that I have a lot of questions and skepticism. And so should you.

Whenever there are articles like this, I look for red flags:

• Is the article edited properly? It might seem like a simple thing, but honestly, if someone in a professional, journalistic setting, doesn't care enough to edit their articles for grammar, spelling, content, and accuracy, they certainly might not care about outright lying to you to get some readership.
• Is the article unusually chipper or eager to present this as an 'all around' solution to a problem? Does it present ALL sides of the debate? Does it present ALL alternatives?
• Does the article portray accurate medical conclusions, information, and accurate explanations, or does it confuse the public about its target audience? 
• Does the article present accurate, statistical data, as has been reported by other research outlets, and scientific journals? 
• Is the study funded by third parties with deep pockets, and deep interests in the outcome of said study?

Taking all these questions into account, let's look at this week's gastric bypass article (which I have linked to above.)

Red Flag #1

The article starts off by telling us about Cristina Iaboni (a woman who was selected as a test subject for gastric bypass in leaner patients), and offers this description of her situation:

"Cristina Iaboni had the dubious distinction of being not quite obese enough. For all the pounds on her 5'5" frame, she did not meet the criteria for bariatric surgery to help control her type-2 diabetes.  

Yet six years of medications and attempts at healthy living had failed to rein in her blood glucose, leaving Iaboni terrified that she was on course to have her kidneys fail "and my feet cut off" -- common consequences of uncontrolled diabetes." 

Right off the bat, I'm kind of concerned about the quality of medical care Mrs. Iaboni may have received. Did her medical team question everything that needed to be questioned? Was she on insulin? When I read "6 years of medications," it literally screams at me that they kept her on every oral medication combination out there, and did NOT put her on insulin, like they should have. What kind of 'healthy living' changes did she attempt to make? Was she she still consuming a high carbohydrate diet, and just substituted her carbs for wheat, and whole grains? Did she even know how to carb count? Did her doctor ever test her for antibodies, and is she a LADA, instead? While the article declares she's 'cured,' I have the strong feeling this woman might rebound down the road.

Red Flag #2


Follow this logic statement with me: "If smoking triggers lung cancer, than smoking cessation should cure cancer."

Oh, it doesn't work that way, you say? Once you have it, you're stuck with it? Oh. Then why do some media and some 'researchers' assume that if obesity triggers diabetes (in those who are genetically predisposed, mind you), that losing weight should cure the diabetes?

The simple answer is "I don't know." The complex answer is "Because they probably have something to sell you."

Certainly, one can assume smoking cessation helps better manage cancer -- I am sure. One will be healthier, and respond better to treatments, and will have a stronger immune system... But one cannot say one is suddenly cured of the cancer. (Even when one is in remission.) Diabetes and weight loss are much the same: weight loss merely makes one healthier, and be able to respond better to treatments (ie, be more insulin sensitive, use less insulin and medications, sometimes none, etc.) These are only ways of tightly controlling diabetes, though, and slowing down it's progression. The absence of medicine is NOT an absence of illness. In this case, it is the strict diabetic patient's regimen that is the patient's medicine. The pancreas has damage, and this damage is irreversible, thus far. It is not, suddenly, magically healed.

Interestingly, this article seems ready to admit (though hesitantly so) that gastric bypass -- since people seemed to be 'magically' better just days after surgery -- proves that a diabetic 'cure' is NOT about weight control, or weight loss. However, here is where the red flag comes in: they are NOT willing to admit that the extreme dietary restrictions a patient must submit to (caloric and, consequently, carbohydrate level restrictions), post op, will play a role and immediately make less glucose available to the patient, and therefore, less high blood glucose issues. Now, normally, a patient who chose to control diabetes with diet and exercise would take a bit longer to achieve euglycemia (or normal blood glucose levels) when consuming a diet lower in carbohydrates and eating 'normal' amounts of food -- but they don't get a head start. A pre-op gastric bypass patient has to be on a type of fast with limited food and liquid intake, so they're already starting out with less available glucose in their system for a couple of days. Yes, they are going to have great numbers in just a few days. Barring other variables, yes, it's that simple, sometimes. I don't think this is rocket science.

Quite frankly, a patient could just go on the restricted diet, and skip the surgery, and achieve similar results... And not that long ago, some of these 'researchers' were practically claiming this same argument: A 'very low calorie diet' could cure type 2 diabetes. 


This article though, quickly sidesteps the discussion and dismisses it without much more than an acknowledgement.


Red Flag #3


The idea that type 2 diabetes begins in the gut is not a new one. It has been, however, a seldom reported one.

More commonly, you see articles speculatively linking the bacteria most known for leading to peptic ulcers (h. pylori), to endocrine disorders (as well as diabetes), and these have been quietly making the rounds since at least 2009, maybe even earlier. There's even an interesting study dating back to 1999, and involving children with type 1 diabetes, insulin requirements, and the presence of h. pylori. The most recent finding came this month, and it involves h. pylori and it's impact on A1C.

The underlying message is clear: bacteria, and inflammation, alter the body's ability to process glucose -- whether in the stomach, or in the gut.

But are the researchers missing the obvious clues? They mention that 'in the past,' patients with peptic ulcers who had surgeries altering their stomachs, and gut connection, 'cured' their diabetes. Or did they just achieve better control of their diabetes because a.) they were now having to, forcefully, eat far less, and b.) the surgery removed chronic inflammation from bacterial infection (which would have dramatically raised blood glucose levels)?

Other articles, and research, have pointed to a bacterial imbalance in the gut as a trigger to an imbalance in processing glucose, and development of type 2 diabetes, but they do NOT suggest surgery for 'curing' the disease. In fact, they suggest a more preventative method -- receiving gut microbiota transplantation. This seems to me like the less invasive, less dangerous, less costly and time consuming, way to go when it comes to researching a cure. Why are we not investing in this? Why is there such a PUSH for getting this dangerous surgery?

The attempts to also connect this surgery to a potential 'cure' or reversal of type 1 diabetes seem a bit far fetched, and improbable to me, and make me question if this researcher has a proper understanding of the etiology of type 1(a) diabetes -- and that it isn't just an insulin insufficiency scenario. I'm pretty sure people need insulin to live, and for many various metabolic functions, and just 'bypassing' a gut mechanism isn't going to make a person insulin independent. I'd like to see more than just three sentences in a poorly edited FOX news article, on the matter.

Red Flag #4


Numbers.

These articles always seem to exaggerate diabetes incidence numbers. This one is no exception. It claims that 8.3% of the world's population has diabetes, and that 11.3% of Americans, have it. Honestly, I don't know where the 11.3% figure came from, with these folks -- but according to the most recent data (released January 26, 2011 -- and not the 2010 date these folks claim) released by the American Diabetes Association, only 8.3% of Americans have diabetes -- and this includes all types, and the undiagnosed. 


Similarly, these folks make these grandiose claims for the 'remission' rates of Roux-en-Y to be 80-85%, and to be incredibly superior to other forms of gastric surgery. But major studies DON'T show that.

"New research reports that no procedure for weight loss surgery is any better at treating diabetes than another. The study, presented May 7 at the International Congress of Endocrinology/European Congress of Endocrinology in Florence, Italy, uses a large ongoing study to show that improvements to diabetes in patients undergoing such surgery is likely to be due to the degree of weight loss itself rather than the type of procedure." (http://www.sciencedaily.com/releases/2012/05/120507102225.htm)

And here's a more startling fact...

"Weight loss surgery is not a cure for type 2 diabetes, but it can improve blood sugar control, according to a new study published in the British Journal of Surgery. Whereas some previous studies have claimed that up to 80 per cent of diabetes patients have been cured following gastric bypass surgery, researchers at Imperial College London found that only 41 per cent of patients achieve remission using more stringent criteria." [emphasis added by me] (http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_4-1-2012-13-32-26)

And that's the ticket here, isn't it? What kind of criteria are these folks using to claim someone is cured? What are their A1Cs, now, and what are their average blood glucose numbers like? I've had folks tell me "I have an A1C in the 6.5% range, so I no longer have diabetes." But wait a minute? That's the number used to diagnosed diabetes to begin with! 

Hey, but you no longer need medicine (for now, anyway), so you must be cured, right? It sounds so pretty... It sounds like such a good sell.

And because it sounds like such a good sell... I give you:

Red Flag #5

"The cost of the bypass surgery is covered by a grant from Covidien Plc, which makes laparoscopic instruments and surgical staplers." 

Oh, so let me see... the people who profit the most from this surgery are the ones funding a study to tell me how awesome this surgery is, how high a success rate it has (even though it is absolutely not supported by independent studies), and how I will just be so cured.

Hmmmmmmmm. Let me think about that. Fox guarding the hen house much? This reminds me of last year, when the ADA published a study done by the Australian Dairy Association, claiming that milk consumption lowered risk of diabetes.

Of course you're going to tell me it's awesome! You want me to buy more of it, and you want me to fall in love with it. You need to make money, too, like everyone else! It's MARKETING.

The problem comes when the money making interests muddle the big picture, and really go against the best interests of the INFORMED patient.

What am I trying to get at, with this blog post? 


Should you avoid gastric bypass? Is it a dangerous alternative?

These are questions you must weigh for yourself... but what I would like to see is for patients to be able to weigh the TRUTH against the hype. NO ONE should promise that surgery will be a success, that it will heal and cure diabetes, or that it will be complication free; but, instead, they must help guide the patient to a point where they can soberly weigh their current health risks against the surgery's very real risks and potential failures. It is easier to accept the roll of the dice when we know that risks are possibilities -- and when we aren't lead to believe that this is just a simple, routine procedure, that will fix our woes forever.

More importantly -- the type of lifestyle changes required by these surgeries are far more demanding than say, pursuing a low carbohydrate regimen (like Berstein's Diabetes Solution, or Atkins), or even raw dieting. If a patient fails at these, or simpler life style changes -- when their life is not at stake -- what makes them feel they could do okay with the dietary demands of such a surgery? Because they got 'two weeks' of psychological counseling pre-op? Disordered eating, and compulsion, take years of counseling to improve (much more to 'fix')!

Additionally, studies have shown that after some time, people's diabetic symptoms may return, and some folks even regain weight and end up pursuing additional gastric surgeries. I am not entirely sure that the costs of surgery, with it's attendant complications, are worth my getting a 'free pass' for a few more years; especially, when I can just give myself that free pass with a more calorie restricted, low carbohydrate diet.

And I don't know about you... but I just like eating food in portions larger than a peanut.

» Read More...

Copyright � 2010 Julie King 
/ Gleeful Things. All Rights Reserved.

Today, I'd like to add a fun, new, regular segment to our blog called "The Moldy Cupcake Awards."

Ya' know... It's just so inspiring to read or watch the news, every week, and see ALL manner of misinformation, quacks, outright lies and drivel, just regularly being fed to the public for the sake of ratings. So, because you've inspired us, ALL of you who are the most deserving for writing, or producing, the shittiest materials out there for the public, will get a wonderful mention here... along with a not so sweet, and oh, so moldy critique.

You've worked HARD (not!) for it, so you're gonna get it! Today's deserving green, stale, sad, and moldy cupcake goes to... The View!

That's right. Earlier this week, the View produced this GEM for it's regular audiences.

 
Let's take a moment to examine this, not so educational moment, play by play. 
Right off the bat, I am immediately annoyed because for all her education, Barbara Walters CANNOT pronounce diabetes correctly. I'm sorry Barbara, it would seem you've spent your free days watching too many Wilford Brimley commercials.
If that doesn't annoy you, then the big letters headlining "The Fat Show," in the background, should. Oh, sure, Barbara, you aren't fat. Let's see your saggy behind in a bikini. I double dare you.  
She goes on ahead, and introduces this man, David Nathan, as the Director of the Diabetes Center at the Massachusetts General Hospital. It should SCARE the beejesus out of you that someone with such a title (and employed at a hospital, mind you) would get on such a show, and FAIL to grasp the opportunity: 

"So I think everyone recognizes that diabetes is a condition where your blood sugar is elevated. We all KNOW that. What many people don't understand is that when your blood sugar remains elevated over many years, blah, blah, blah... feet falling off... blindness... blah, blah..." (Okay, that's not entirely, a literal quote.) 

Dr. Nathan, for someone who calls himself a doctor you are surely very disconnected from reality.

1. NO, people do NOT know what diabetes is about. You could've spent a minute or two, telling people that our condition is a condition in which the body FAILS to be able to process glucose adequately, and that ALL food gets converted into glucose. NO, people do NOT know the difference between sugar, and blood glucose. People think if we just stop having Paula Deen lady donut burgers, and ho-hos, that blood sugar goes down, and diabetes goes away.

This is the kind of situation that gets people bullied by idiotic people thinking they can take on the role of diabetic police.

2. Meanwhile, everyone DOES know the serious complications diabetes may bring, so since they associate them with eating too much sugar, they are ALWAYS making jokes about our feet falling off, and us going blind. You could've clarified a little better that well controlled diabetes is the main cause of NOTHING... But you really missed the boat on this one. Thanks for letting the bullying cycle persist.

Now, I don't really understand why The View would have Paula Deen as some kind of 'interviewer' for this segment, asking things she really doesn't understand because she's just too new, and uneducated -- but it matters not, because this Dr. Nathan fails to answer her questions directly. She asks him what the connection is between obesity and diabetes, and he doesn't really say... He just muddles the picture by starting to talk about other majorly recognized risk factors, and how now, younger folks are getting diagnosed because of weight. Okay? So tell us something we DON'T know. Why not tell people "gee, the more you are overweight, the more your body will struggle to produce insulin -- and if you are genetically predisposed to insulin resistance, and diabetes, the more it will likely trigger your developing the condition at an earlier age..." Is it that difficult to speak to people with truth and honesty, and clarity? Do we think The View's audience are a bunch of simpleton housewives, who only know about dish soap? I wonder...

Oh, and I love how you describe Type 1 as "the insulin dependent, juvenile form... the Mary Tyler Moore form..." That's metaphor, right there!! A definitive moldy cupcake award for dialogue. Here's a TALL idea, for you: how about calling it the "my autoimmune system sucks, so it attacked itself" form. People will have this FOREVER, and can get it at ANY age. They don't grow out of it, and gosh darn it, MANY adults, every year, get it... WAY past their 'juvenile' years. Oh, and to add to it, you make it sound like type 2s don't need insulin, when in fact, if a type 2 diabetic is diagnosed early enough in their lifetime, they will more than likely need insulin before they die. MOST type 2 diabetics will go on to need insulin. It's a fact. Hell, it's an American Diabetes Association researched fact -- even when they're trying to act like it's not. 

One thing is pretty juvenile, though -- your casual approach to discussing diabetes. You nailed that one right on the head.

Now, dear Paula Deen tries so hard to stay relevant in this discussion. Paula, honey, NO ONE is born with type 1 diabetes. And I think an awful lot of parents out there would kind of take offense to your portraying their children as like 'having leukemia.' I say this, because while type 1 diabetes can be deadly and challenging, we all know you weren't trying to suggest they were 'troopers, fighters, survivors, and well adjusted kids...' No, you were trying to suggest they were sickly, weak, and likely to die from sneezing. Paula, I support your journey with diabetes, but sometimes... you gotta shut your lady burger pie hole. Okay? We should not comment on things we know not about.

I am not completely angry at the intense stupidity of this segment (okay, I lied...); I'm actually happy for your patient, Misty. I'm happy she's doing better, and is healthier.

What I'm not happy about is that Misty doesn't seem to understand what a diabetic diet is all about. She keeps talking about sugary drinks, sodas, juices. She doesn't talk AT ALL about controlling her carbohydrate intake, carefully weighing out her meals and portion control, in any way. In fact, NO ONE ever mentions carbohydrates and their role in any way -- and continuously focus on sugar!

Dr. Nathan, this is the BIGGEST disservice you can do for people -- letting them go on believing that diabetes is about sugar. IT IS NOT. Diabetes is NOT about juice boxes, soda, cookies, etc. It takes a hell of a lot more effort to control diabetes than to just cut out soda and juice boxes. In fact, I am so scared of Misty's apparent lack of knowledge of what it all entails, that I truly wonder what her A1C is, and what you justified to yourself was "excellent control" to make it seem she needed to get off the Metformin. I guarantee it's not in the 5.0-6.0 percent rating. It can't be. Not with her thinking it's just sugar. She probably goes home and has a plate full of wheat pasta, and calls it good.

"That's the beauty of type 2 diabetes... is that it is reversible." 

Diabetes is not reversible. Whenever folks discuss diabetes as 'reversible,' what they are referring to are the symptoms of uncontrolled diabetes. Blurry vision, dizziness, slow healing cuts, some forms of early neuropathy, thirst, continuous urination, headaches, mood swings, etc.

I have news, for you Paula... You'll still have diabetes, even when all those things are gone. You live life so that you CONTROL those things -- but you can't stop your routines, or those things WILL return. And quickly. Your diet is your MEDICINE. It's just exactly like medicine.

In this sense, Paula... ALL diabetes is reversible. Yes, even type 1 diabetes. It's a BOLD statement, but I know some pretty TOUGH type 1 diabetics out there that could run circles around me, any day, and to the average world look like they have NOTHING wrong with them. They have worked hard to REVERSE the horrible grip of uncontrolled diabetes which they had at diagnosis. TIGHT control is what we ALL aim for -- but it takes CONSTANT work and effort, and it is SO not a cure.

Photo by RingoFuentes

You can't go on living like just testing once a day, and not knowing what carbs do to you is, somehow, having diabetes in control. It is a full time job, and it causes a lot of psychological trauma, and exhaustion. There's just NO beauty in this pile of dung. (But you'd be a little prettier if you spoke a little less. :) Thank you.) The beauty is in US -- and how we evolve to adapt to the harsh winds of diabetes.

Additionally, Dr. Nathan, it is embarrassing that you would suggest to people that all they need to do is lose a modest amount of weight to better manage their diabetes -- this is untrue. While weight loss helps lessen some of the challenges of insulin resistance, it is NOT the way to control diabetes -- the way to control diabetes is to control one's diet and carbohydrate intake, along with weight lifting and resistance training, and sometimes, medication. When you tell people that losing 5-7% of their weight would reduce diabetes by 58%, you are leaving them with a lot of confusion, and mixed feelings. I mean... what the HELL does that even mean?????

You can't reduce diabetes by 58% when YOU ALREADY HAVE IT.

You must be talking about the poorly done, not so large, diabetic studies... who used a lot of extrapolation, inference, and ignoring of many, many additional risk factors and components, along with populations that did NOT represent a cross-section of the country... to claim that 58% of diabetes could have been PREVENTED. Which is another poorly used word. One can only REDUCE one's odds of disease -- not eliminate them. There is NO SUCH guarantee that you won't get diabetes, even if you do 'everything right.'

So, Dr. Nathan, Paula Deen, Barbara Walters... for all these reasons -- and I'm sure -- many more... You have earned yourself a Dung Cupcake. But they don't make dung cupcakes, so here's a moldy one, instead. You've earned it.

One big, so not so heartfelt, THANK YOU... for all the work you DON'T DO. You make the world one heck of a crappy place for diabetics everywhere.

(Oh, and in case you didn't get it... That's called sarcasm. It's a young people thing.)

. . . 

If you would like to submit 'nominees' for the week's crappiest stories worthy of a Moldy Cupcake Award, feel free to 'Contact Me,' and they shall be thoughtfully considered. :D We shall leave no moldy cupcake left behind. 

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With the rising tide of juvenile type 2 diabetes, the debate on school lunches is one which is slowly starting to take the stage. It is, however, one of those subjects in which everyone has an opinion -- but not many have an actual evidence based opinion. Throw in the wrench that every school district is different, and you'll find mudslinging from all sides of the opinion spectrum:

Why can't parents just make healthful lunches for students? 

Well, right now, some schools are actually BANNING parents from preparing school lunches for their kids, claiming it is the parents making unhealthful meal choices. Of course, this is often true... No one can deny that. But it also makes many of us with diabetic loved ones CRINGE at the thought of what a school cafeteria lady, or health department, might think is a healthful school lunch. These places often lack in options. I'm thinking a main course of carbohydrates slathered in cheese and hot dogs, with a side of carbohydrates slathered in butter or salt, with a dessert full of carbohydrates, and a glass full of carbohydrates (because it has vitamins, so it must be good for your health, unlike that can of soda.) Your main sources of protein come from that powdered, grade A government issued cheese, and that powdered, grade A government issued milk. YAY. To top it off, throw an apple at it, for good measure, because apples make ANYTHING look healthy.

Some will argue, why can't parents just trust the school lunch system? 

'I always got healthful meals from the school system, and I turned out JUST fine.' I love these people the most. To them, anecdotal evidence is ALL the evidence that anyone will ever need, and it somehow, trumps everything. It's like seeing nothing but yellow parakeets, and assuming there are ONLY yellow parakeets in existence because that's all your local store carries. (Never mind that many of these folks have NO IDEA what a healthy meal even looks like, and tend to think that all a kid needs to do to stay healthy is to avoid candy and soda, and eat lots of fruitsandvegetables.)

Well, here's something that will blow your mind.

Did you know that the original idea of a 

'food pyramid' started  as a way to help 

ease food costs by spending money on basic, 

cheaper foods, and still get nutrition? The rest 

of the foods were meant as complements 

to enhance whatever nutrients were missing. 

Ever since the USDA started making low fat, 

high carb recommendations in the 80s, and 

implemented it's OWN food pyramid in 1992, 

obesity rates have skyrocketed.

The USDA describes their National School Lunch Program as: "a federally assisted meal program operating in public and nonprofit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to children each school day. The program was established under the National School Lunch Act, signed by President Harry Truman in 1946."

Right away, when you brush away the chaff... what should jump at you is the 'low-cost' descriptor used in this paragraph. What does this, casually thrown in, adjective have to say about this program? What is hidden between the lines? Well, what they don't tell you is that the National School Lunch Program started as a way to help a poor, starving population, through government subsidies --  the same subsidies programs which are still, to this day, overpowering our agricultural industry, and making it possible to produce mass amounts of low quality, less nutritionally dense foods. (McDonald's anyone?) When you invest in low quality, less nutritionally dense foods, they become LOW-COST, and easy to mass market to a multitude of industries, and other countries. Smaller farms CANNOT compete with the HUGE agribusiness industry that has come to dominate the markets, including... you guessed it -- the school lunch program market. While the school 'lunch ladies,' might VEND food for you, it usually comes pre-packaged, pre-made, or 'ready to make' sources, and local state federal agencies will contract their local school lunch program to a food service management company, to save a few bucks. If your local school district does not contract to one of these, they are the EXCEPTION.

The three companies, right now, that dominate the industry are Aramark, Compass Group, and Sodexo. They mass market less nutritional foods, serve nutritionally imbalanced meals, cut corners to save dollars, and contract with fast food giants to market to kids -- yes, including, soda manufacturers. Not only that, but they have been under investigation in the past, for serving foods SO low in quality, they were rejected by fast food industry safety standards. (It's gotta take a lot of balls to serve a kid something WORSE than fake fast food meat.) They have such a strong arm in the system, many of them have been able to lobby, and block legislation that would improve standards, including legislation that would have banned soda vending machines in some schools, for example. 

So when you throw in less nutritionally dense foods (so, even if you have a small serving of them, they're still not so great for you,) in an array of unbalanced meals (all carbs, and hardly anything else), no allowances for or enforcing of portion control (and just eat what you want, and how much you want of it), and the attending results of kids who will a.) not feel the stop and go of their hunger signals anymore, and b.) constantly feel hungry because they got no real nutrition, you will get increased likelihood of illness, development of chronic diseases, and a national fat kid tsunami.

That's right... every time your kid eats at one of these national school lunch programs, it's eating food that's probably worse than McDonald's. (And even if it would appear "balanced," the fact is... it's still food that is nutritionally inferior. Remember that. It's like comparing a home made creme filled cake, to a Twinkie. They are technically, the same thing, but that's where it ends. One of them still has FIBER, and many, many vitamins and minerals. I'll let you guess which one that is.)

Are you freaked out yet? YOU SHOULD BE.

Still, some people have blind faith in their National School Lunch Programs... And disbelieve or disregard those who try to stand up against it, and call for change. (Including some politicians.) But folks are fighting BACK. 


Folks like Sarah Wu, who "compelled by her own frustration with school meals � both as a mother and a teacher ... known anonymously as "Mrs. Q." committed to eating school lunch every school day in 2010 just like her students. Mrs. Q documented her experience and described the meals by blogging, tweeting and sharing photos on her blog Fed Up With Lunch: The School Lunch Project." Her blog is one of the first blogs to help capture national attention on this very concerning issue. Mrs. Q risked her employment on this... and there were many days I worried she'd get caught. Still, I cheered for her. Her voice has been effecting some serious awareness and change... but we need more.

More, nationally, as well as globally... Like little 9 year old, Martha Payne, from Scotland... who writes about her poor lunch school program at NeverSeconds. While you're not going to see her giving you an in-depth analysis on the corruption, and backdraft, of agribusiness subsidies... she will hold up every meal to critique, and scrutiny, so you can see with your own eyes what she and her peers are being served.

. . . 

America is at a critical point, right now... we are at a point where it's starting to matter very little what type of food you eat, because it was all cheaply made, and nutritionally bankrupt. Movies like "King Corn," "Supersize Me," and "Food, Inc.," have created some discussion... but quickly get swept under the rug as 'passing the buck,' and not taking personal responsibility for what we eat. But we are clearly living in a very obesogenic environment where it is getting increasingly difficult to make right and wrong decisions, and increasingly easy to be deceived. Yes, a lot of foods that make false health claims have food labels, and we could be better trained and educated at reading them... but what if we thought we were eating meat, and instead were getting meat with an incredibly high risk of bacteria, and lots of corn filler? What if it was given to us by a school lunch program, with no labels (just trust), and not the 'you should know better,' fast food industry?

Yes, we have freedom of choice, in America... as to what we eat. But to what EXTENT should we let the government and the food industry tamper with our food supplies? Market to us? To children who haven't yet developed some of the necessary critical thinking skills, and disciplines, to make good life choices? (Especially, when they don't even have a parent around, to help...) Or to populations with less income, less education, and less access to nutritious alternatives?

The rights and freedoms of those who want to make me less healthy (and not just by consuming more 'fats' and 'sugars,' mind you), start mattering VERY LITTLE to me... when the lives of children, and the future of our nations are involved.

I don't know how ALL chronic illnesses, cancers, and autoimmune conditions come to pass... but sometimes, I have a very good idea what might be contributing to their explosion... And it's not just having an extra piece of pie.

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Here at the Angry Type 2 Diabetic, we see 'ourselves' as a voice to ALL persons with diabetes... So, even though we generally use this space to share about our own type 2 diabetic experiences, we'd like to cheerfully lend the spotlight, this week, to our friend, Michelle. Michelle is a wonderful mom to a type 1 diabetic child, and she has a very important message to share with ALL of you. You may find Michelle's regular blogging space at The Tightrope Tango, and show her some follow love.  

My name is Michelle, and first I want to thank my good friend Lizmari for lending me space on her awesome blog. Lizmari is an awesome advocate for all people living with diabetes, regardless of type. She�s also the reason we enjoyed some pretty awesome Ice Cream Sundae�s last August.

Most people I talk to (and I talk quite a lot these days) have never heard of a diabetes alert dog. We all know about Guide Dogs for the Blind, and most of us have heard of dogs to assist people with other disabilities such as mobility, seizures, hearing, etc. Diabetes alert dogs are specially trained dogs that focus on the scent of their person, and let that person know when their blood sugar begins to drop to an unsafe level. These dogs are most commonly used by people with type 1 diabetes, but some with type 2 diabetes are also using diabetes alert dogs to keep them safe.

Why is this necessary? Well, a lot of diabetics either never have, or lose the ability over time to sense changes in blood sugar. My daughter, Sarah, is 12. She�s had type 1 diabetes for about two and a half years. Since the beginning she�s had trouble recognizing when her blood sugar is low, until it is dangerously low (sometimes in the 40�s and 50�s mg/dL). Normal blood sugar (for a non-diabetic) ranges from around 70mg/dL to 130mg/dL. If blood sugar drops too low, unconsciousness, seizures, and death can occur. Sarah has difficulty feeling drops in her blood sugar during the day, but she does not feel them at night, period. Since she�s been diagnosed, she has never� not once� woken because she felt a low blood sugar. That is scary. The JDRF (Juvenile Diabetes Research Foundation) reports that 1 in 20 people with type 1 diabetes will DIE of a low blood sugar. 1 in 20! That's not a typo. It's not 1 in 20,000, it's 1 in 20. (http://www.jdrftalk.org/2011/11/07/percentage-people-type1-diabetes-die-low-blood-sugar-hypoglycemia/). I can�t let my beautiful child become a statistic, so right now I set alarms for 10:30, 11:30, and 2am. Sometimes more, sometimes less, depending on her food and activity for the previous day.

But I�m not perfect, and I make mistakes.

Once, last December, she went extremely low (27mg/dL). She was unresponsive. It was only around midnight and I only caught the low because I checked on her and found that she was horribly pale and covered in sweat. I saved her life that night, because she was still dropping and the body can't sustain a blood sugar much lower than that for very long. If I hadn't checked on her, she very easily could have slipped into a coma and been gone by morning.

We tried a CGM (continuous glucose monitor) but Sarah has a metal allergy and gets a severe rash. This is where the diabetes alert dog comes in. Diabetes alert dogs are not for everyone. They require a lot of care. They eat a lot, they poop a lot. Honestly, in the beginning I thought that a diabetes alert dog was too much responsibility for a child. But my child proved me wrong by volunteering many hours every month with Guide Dogs for the Blind. She learned to handle, groom, and correct them. She grew to love her new friends, and has taken weekend responsibility for a Guide Dog puppy on a number of occasions. 

I believe that in a few years, maybe 5, maybe 20, that diabetes alert dogs will be much more common and understood. Discounting the fact that an alert dog is a living animal, an alert dog is a medical device, a tool. An alert dog is always on watch with their wonderful nose. An alert dog can think, and will go find help if their charge doesn�t respond to their warnings. Guide Dogs call it intelligent disobedience, a term that describes when a dog makes a decision to take an action outside its normal training that is in the best interest of their person. This could be a dog that leaves Sarah�s side during school to go take the alert to the teacher or other adult. This could be leaving Sarah�s room during the night to come into my room and let me know that Sarah needs help.

The last thing I�d like to say to everyone who reads this is to not discount the needs of someone with diabetes simply because they don�t have an obvious disability. Many kids, like my Sarah, are active, funny, enthusiastic, and because their health, food and activity is watched very closely, they often appear healthier than the average child their age. I�ve had a few eyerolls when I�ve told people that my bouncy child, who just exudes health and vitality, needs a service dog to keep her safe. For someone with type 1 diabetes, safe and healthy require a lot of work, lots of acting on instinct, guesswork, etc. It�s not as easy as it looks, and even with constant effort we have lows and highs that could not have been predicted. Diabetes is always. It never stops. It never goes away or gives us a break. Sarah takes large doses of insulin 4-6 times a day. Any one of those could send her to a fatal low if she or I misjudge the carbohydrates in her food or misjudge how her activity will affect her.

Can you be 100% right ALL the time?

At this time, diabetes alert dogs are not covered by insurance. Those of us who have made this choice for our child must generally pay for the cost of training the dog. My hope is that once the abilities of these dogs are more fully understood and accepted, more groups like Guide Dogs for the Blind can be formed to raise funds and provide these amazing dogs at low or no charge to the family. The first step in making this a reality is education. Tell someone you know about these dogs, and help spread the word. Even if you don�t know someone with diabetes, someone you know does.

Talk. Educate. Your words can help save someone�s life.

If you�d like to learn more about Sarah�s journey to a diabetes alert service dog, please visit either her facebook page at https://www.facebook.com/ADiabetesServiceDogForSarah or her website at www.pawsforsarah.com. Sarah�s dog is coming from Canine Hope for Diabetics in Riverside, CA, hopefully in early 2013. 

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"I do what I have to do, so that I can do what I want to do."

Life is not a simple exercise for me. While it just seems to come naturally to some, it's just not so, for me. Having a positive state of mind is a continuous choice I have to make, and it is a continuous decision to stop self destructive thoughts in their tracks, and choose to believe the positive mantras that might seem cheesy, or ludicrous to me.

I don't really know why I am like this... and I could psycho-analyze it to death, but I'm not sure how helpful that would be. I'm pretty sure that some of the hurdles I've faced (especially in my childhood) have helped me develop a somewhat dim view of the world. Things like childhood obesity, a grim personal appearance (thanks to undiagnosed PCOS), constant exhaustion and mood swings (thanks to undiagnosed Hypothyroidism), uninvested parents and a lack of personal development, etc.

I felt so alone most of my childhood, and so inadequate, that I spent it trying to pursue instant gratification. In my teen years, eating and TV became my sole companions and comforts, while my family was mostly off in their own world. It's still like this today, you know. I don't get social phone calls from family, nor so much as a card on a birthday, or a holiday... and quite frankly, I don't remember the last time I got anything at all in the mail, from them, or even a social phone call. You can see why a child would try to drown itself with 'love' in the form of whatever one came across -- be it food, or TV, or what have you. Pick your poison.

When one is swimming in loneliness, illness induced mood swings, life induced anxiety, and self loathing... it is extremely hard to have self control of any kind. Whether it be with your refrigerator, or with your checkbook, or whatever brings you immediate release. What's worse is that when you don't have deadlines or commitments of any kind, you can put off desperately needed changes, for as long as possible and tell yourself that 'tomorrow, you will start;' but when someone tells you that you have NO choice, that it's the hour zero and you need to buckle down, or else... your life turns into a shiny, red button. Do not press the shiny red button, they say... You must guard yourself to never press the shiny red button. Everyone's anticipating, and policing you. Everyone knows.

History Eraser Button

If the video doesn't show, follow the link above.

This is what life is like for many of my fellow type 2 diabetics, right now... A shiny red button. It's easy to understand how one gets to that kind of place, and ever soooo hard to help someone get out of that place, see the light, and understand that although life may be smacking us with its behind (like the announcer guy on this Ren and Stimpy video), that we have a choice. We indeed have a choice, and our lives don't automatically go down the drain... Our destinies are not planned for us. We MAKE our own futures; we write them today.

Someone I admire profoundly, once said to me: "Lizmari, you are no one's victim." 

But it's so comforting to believe that I am; that I am life's victim, that I have no choices, that I am like a small boat, with no sails, and no paddles... at the mercy of life's waves. That I am being held hostage at the mercy of a big, shiny red button, awaiting to erase history; MY HISTORY. Or at least, in my warped sense of self I like to think it is... "Woe is me..."

Why? Because it's PAINFUL to not be anyone's victim. It takes MUSCLE, and exercising your discipline muscle is just as painful as stretching your calves. Ouch. 

... But I am not anyone's victim. I AM NOT, and neither are you. 

Listen to me, friend. You who decided to google "When will I die from Type 2 Diabetes?" and suddenly chanced upon my blog: You are not a tiny raft, alone at sea. You are a MASSIVE ship, and you can take charge of your course. You can choose to stir your ship into the icebergs, you can choose to press the shiny red buttons of your life, every day... Or you can choose to tell diabetes to buzz off.

"Hey, diabetes... GET LOST. You may place hurdles in my life, but you will NOT take me. Not today. TODAY WILL NOT BE THE DAY. I am NOT your victim. You are NOT my master. I AM, and I am allowed to BE, and you do NOT get to tell me who I am, what I am, and when I get to leave." 

I have my own shiny, red buttons... and I understand. Believe me, I do... 

But you have choices... And while you may decide to throw in the towel, let me remind you (or perhaps inform you), that Type 2 Diabetes =/= death. YOU have the power to let it equal LIFE. A life reborn, a life re-defined, a life EMBRACED. 

Embrace life, WITH diabetes. It may take courage to not be a victim... but I promise you, if you do it, you will NOT be disappointed. You will be OKAY. You will not just survive, but you will THRIVE. You can do this thing... Life awaits you! 

I promise. 

Will you take the challenge?

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(See Also: Diabetes and Anger -- Is there a Deeper Connection?) 

This angry diabetic has been really bewildered for the past few weeks with many new and personal challenges...  As we know, life's problems do not stop at diabetes, or any other chronic illness, nor do they care if we're having to juggle other things. In fact, in the storm of life... sometimes when it rains, it just pours. (I need to buy a raincoat.)

So, I thought... why not take a little time to address a common, and often overlooked, issue with diabetes? Anger. In the past few weeks, my blog has registered many, many Google searches for "anger and diabetes," "do diabetics suffer from anger," "do diabetics need anger management," etc. I fear many of these folks might be family members really wanting to understand, and care for their loved ones... or maybe folks just wanting to understand themselves a little better.

Before I get a little further into the discussion, I want to add that while the emotions we experience through the ups and downs of illness, and life, are perfectly normal... this blog post is in NO WAY a justification for aggression, violence, or abuse. It might be an EXPLANATION of a course of events, but in the end... we are responsible for our own selves, and how we manage our health, and our emotions.

Got that? Okay... :)

Diabetes is a PERVASIVE disease...

Now, in order to make some of kind of sense of the emotions a person with diabetes might feel, we need to understand one thing: Diabetes is a PERVASIVE life change. It is one of the most pervasive life changes an 'afflicted' person will ever have to face. While it may not seem as such in the beginning stages (especially for type 2, and often during a "honeymoon phase" for a type 1), with time, an individual will soon become painfully aware of just how MUCH diabetes will demand of them.

Diabetes demands that we (and often our loved ones) learn a LOT of information in a short amount of time, and often more than many medical professionals; that we completely change how we view our eating habits, and what we consider healthy according to the whims and demands of a little electronic gadget called a 'glucose meter;' that we throw away the information we once thought made SENSE, for a new, and obscure world which we merely go about feeling, through the grace and support of others who have been there before us; that we are on alert to protect ourselves from the harm of careless outsiders, or clueless third parties. It demands that we learn to 'forecast' how meals will affect us, depending on their level of carbohydrates, fiber, protein, and fat, and sometimes... algebra, and the phases of the moon! :) And yes... just to throw a nice wrench in it, diabetes often demands FAMILY UNITY and outside support. Diabetes... is a THIEF of spontaneity. It demands you plan out almost every moment of your life.

Let's face it, if most of us got into a relationship with someone who was like this, we'd call them CONTROLLING... And most of us can't handle change very well, let alone pervasive change. A social network like Facebook changes how some things look, and feel, and millions of people get up in arms, and feel imprisoned! Living in harmony with a controlling, and demanding disease like diabetes, is NOT an easy feat for the weak-hearted, or for those who fly off the seat of their pants. It is HARD work; often 24/7 work. It is like chess; one always needs to think 2 or 3, or 4 moves ahead. If you snooze... you lose.

Diabetes makes us feel judged... 

Being diagnosed with diabetes, in itself, can be anger inducing. We often feel like we have failed somehow. Whether it's type 1, or type 2, folks often feel a big burden of guilt over past habits or parenting, or perceived flaws (however erroneous those might be.) Often, folks who were diagnosed with type 2 diabetes may have been fighting, or struggling with weight and eating habits for years, before feeling like they were given a 'death' sentence for 'failing' to make the grade at these tasks. To top it off, few medical professionals discuss how BIG the role of our genetic make up is when it comes to diagnosis, and how even folks who are thin, or otherwise in relatively good health, can end up with a diabetes diagnosis.

Instead, diabetes is portrayed as the disease of the obese and inactive, and not simply a disease in which our immune systems are more sensitive to unhealthful triggers, thanks to our genetic make up. Many things like alcohol, smoking, other medications and illnesses, as well as pollutants or pesticides, may trigger a diabetes diagnosis. Some of those triggers, we may work at reducing their influence; some, we may not. One works at REDUCING the risk of getting diabetes, but the use of the word "prevention" is a potentially judgment inducing misnomer.

Diabetes is poorly understood... 

Diabetes doesn't just bring with it a lot of self blame... It often brings with it the blame of outsiders who poorly understand this disease. This is, in part, the fault of our current medical professionals, and in part, the fault of our media who is looking to market to, and cash in, on a 'growing' population.

One would think that for such a deadly disease, there would be many prepared and able medical professionals, and certainly... there are some great ones out there. However, the amount of uneducated, misguided, and often, dangerous medical professionals out there, is staggering. Many patients, particularly type 2s, are left out in the dark... with little information as to what they have, and how to proceed. They are often kept from access to specialists, educators, testing tools, and insulin... so managing this disease, and learning how to do so in what one would think should be a safe environment, are often HUGE, and frustrating, hurdles. Many folks end up erroneously thinking this is a disease of avoiding sweets -- which it is not -- and are left not understanding why they can't make strides, and worse, being judged and labeled as "noncompliant."

The amount of new information we are learning about diabetes, every day, is far outpacing the amount of continuous diabetic education many medical professionals are receiving. This leaves us with a world of antiquated guidelines, and outdated diabetic organizations... leaving many patients out there, clueless, and confused.

Diabetics are poorly understood... 

It follows that because diabetes is such a pervasive disease, and such a complicated and misunderstood disease, that diabetics themselves would be misunderstood.

Many folks can understand the need to keep a home free of elements that might provoke a deadly allergy, in a family member, such as nuts... Few folks can understand what it's like to have to completely re-structure a life after a disease, and require the support of the entire family unit to achieve it. Often, family members or friends, might think that diabetes is just the person's problem, and that they don't need to contribute or support in any way. They don't want us to "cramp" their style, or to have to change on our account, in any way. Often, for example, if a person with diabetes is the cook in the home, they end up making different meals for their family, or may even get little acknowledgement for their desire to have a healthier pantry in the home.

Feelings of frustration, anger or resentment, are often met with snide comments of disbelief: "What's the big deal? You can eat that...," "Just diet and exercise and your diabetes will go away...," "So? Just stop eating sugar...," "I don't see why you feel so sick, you must be faking...," "You brought this on yourself, anyway... It's your fault... I'm not the one with diabetes...," "Please don't bore me with your disease...," "At least it's not cancer...," etc...

For the diabetic, it's often a lonely world, especially if one does not have a support group to vent in. Our struggles often go unacknowledged, and we can be viewed as drama queens, or hypochondriacs 'obsessed' with our disease. It is a 'nuisance' for others to change, especially if that change is INDIRECTLY related to them. Diabetics will often feel left out of activities involving food, particularly if the items are challenging and no longer doable for them.

Diabetes brings scam artists and opportunists... 

Often, our loved ones who DO try to help fall prey to media misinformation, scams, and opportunists. This is not surprising, since there is so little accurate information out there, it presents an information vacuum for predators and those who want ratings and readership, and a trap for folks who want hope, and are not getting the right education and attention from their medical teams. We live in a society that wants quick answers, and quick remedies, and quick blame... and is prone to gullibility. Unfortunately, scammers want a quick buck, too... and many "doctors" have long abandoned their Hippocratic oath, over worship of the all-mighty dollar. (If it's a TV doctor, or a doctor with complaints or cures about EVERYTHING, and an opportunity to sell you an expensive supplement or product to fix it, or a book to cure it... He is NOT a true doctor. If every doctor or 'specialist' in the article you just read looks like a super model of some sort, they are most likely NOT 'nationally renowned.')

Unfortunately, actual medical professionals have been guilty of misleading regular folks with promises of gastric bypass cures, and diet cures, as well. Telling folks if they just lost weight, they wouldn't have diabetes anymore... or treating them like school children who need pass and fail grades. Recently, a famous 'study' hawked the 'curative' properties of gastric bypass, but what NO ONE noted was that the company sponsoring and paying for the study was the medical company PROFITING from the gastric bypasses. (Yes, I am sure cigarette companies would just LOVE to tell me how healthy cigarettes are for me, if left to their OWN designed studies.)

Now, a well educated diabetic, constantly on their toes about misinformation can CATCH these tricks full of smoke and mirrors, but a relative who is not in the middle of the fray, or a well meaning friend or person, is not as apt to pay attention, and more likely to assume or rely on the 'goodness' of the medical establishment. I mean, why not? This crazy study was published EVERYWHERE; even the New York Times.

Opportunistic journalists often feed on opportunistic headlines from opportunistic profit seeking groups, or doctors, and this creates a world of hurt, trouble, and often anger, for many persons with diabetes.

Diabetes is PERVASIVE in ignorance... 

I wish diabetes was JUST a misunderstood disease; the problem is people will make decisions BASED on that ignorance, and misinformation.

Doctors choose to not educate themselves because it's a disease that can be 'avoided' and it's the person's fault; insurance companies choose to not cover services, supplies and medicines, and testing tools, because it's a disease that could have been 'avoided,' and it's the person's fault; employers choose to not respect diabetic's needs because they see them as 'making stuff up' because according to many poor doctors, it's 'no big deal,' and it could have been 'avoided,' and it's the person's fault... and it keeps snowballing and snowballing.

You get the idea.

For diabetics, proving themselves as worthy patients, employees, friends, and family members, is often a daunting task. NO ONE today would dare go accusing someone with AIDS of giving themselves a disease, and chastise them; however, this is often the bread and butter of diabetes... Especially, type 2 diabetes and small children with type 1 whose parents often get accused of having given them 'too much sugar' as babies. I mean, who thinks that? Do you know any moms out there who filled their baby's bottles with pixie dust sticks? I don't...

Diabetes BRINGS mood swings...

Anger, depression, loneliness, you name it. When our blood glucose levels get either too high, or too low, our moods WILL swing back and forth. Mood swings can vary between just general grouchiness, irritability, to violence (especially, during low blood sugars, when we may have little control over who we are.)

It's bad enough dealing with this scenario, but often friends just make us feel 'belittled' when they ask "Can you check your blood sugar?," if we share our emotions, or our frustrations. I admit, it's sometimes not so easy to tell... but if you're in the middle of a rational argument with someone, do not stop to ask them this; it's quite the same as asking a woman if she's on her period. I don't condone violence, but I can't say violence WON'T happen if you happen to reduce someone's honest views or emotions to a blood glucose episode.

How can I help? 

Be an active "reader", and consider your friend or loved one with diabetes, as an open book; that is, listen more, and talk less. Read more, and assume less. Seek to learn, and seek ways in which you can be of help. Instead of suggesting actual tasks to 'police' your diabetic's behavior, you may ask an open ended question, such as "Is there anything I can help you with?" Or, "I have noticed you struggle with x, y, and z... is there anything I can do to make that easier?"

We can help our diabetics by "dividing and conquering" tasks, like bringing back up glucose supplies, or calling ahead to find out what meals will be served at events, or friends' places. We can even help by making a favorite diabetic's dish to bring. I don't know why, but these small things that take away my 'spontaneity,' are the ones that peeve me the most. If I have someone else as a back up for my forgetful mind, I don't have to feel so vulnerable at those times.

Invest your life alongside your diabetic friend or loved one's life -- I mean, you want them around for a lot longer, right? Why not go to their support groups with, or their diabetes educator sessions...? Ask thoughtful questions that do not put a person on the spot; you can ask about what a hypoglycemic event is, and feels like, when the person is NOT in the middle of one, for example.

Embrace a HEALTHIER life. Do not treat the diabetic's new life changes like they are a death sentence, but as a wake up call to the entire family that they need to be a bit more conscientious of what they eat, portion, and manage. If they are related to you by blood, it might benefit you ENORMOUSLY to follow their eating regimen and lifestyle, and get used to it now... while you don't have the strong pressure of complications looming over your head.

Finally, if your loved one, or friend, is greatly struggling with uncontrolled anger, and depression, remind them that it is OKAY to feel that way, and that it is OKAY to need some help sometimes with the overwhelming burden of managing a controlling, and demanding illness. Diabetes is as much a  psyco-social disease, as it is a physical disease, and it WILL require outside support, and often require therapy.

This blog post is by no means exhaustive, but I hope to have at least shed SOME light for many of you on how being a diabetic can change one's world view, and bring with it, many unwanted frustrations, resentment, and often anger. Much of that anger we can grow from, and overcome, and some of it will forever linger... as is the nature of the disease, and the world we must face as diabetics.

Do you have questions, or topics you would like for me to cover? Feel free to let me know. :)

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