Miss Diagnosis

This is a boring rehash of every other diabetes article everywhere in the media, and it ought to be obvious from the statistics that this type of scare-tactic, victim-blaming/shaming reporting IS NOT HELPING.

Despite the genetic component, type 2 diabetes is almost completely preventable.

O RLY? How many other diseases with a "genetic component" are considered "almost completely preventable" (and so what's wrong with you for not preventing yourself from getting sick)? If it actually were the case, one would think that diabetes would be prevented by now, given that these talking points can be found anywhere and everywhere the topic arises. Contrast Miss Diagnosis' "facts" with this recent statement from Diabetes Daily:

Lastly, let's clear up a major myth. When someone gets type 2 diabetes, it is not their fault. Type 2 diabetes has a strong genetic link (even more so than type 1). If your twin has type 2 diabetes, you have almost a 100% chance of developing it. While staying fit can substantially delay the onset of type 2 diabetes, it does not guarantee prevention. If you have the "right" genes and live long enough, you will most likely develop diabetes. And if you don't have the genes? You can gain weight and barely increase your risk at all.

If you were someone with diabetes -- which the people that write these useless articles almost never are, oddly enough -- which set of ideas would help you more -- "You're going to die horribly and it's all your fault, plus you're costing us a buncha money you lazy fat pigs!" versus "It's not your fault, let's talk about what you need to take the best care of yourself that you can." As a person with diabetes, I know which one I pick, and I'm sick and tired of being blamed for my difficulties and addressed as though I'm too stupid to know what's good for me by authors of articles like this one.

I would think that, given the health care crisis that's all over the news, Miss Diagnosis and that radical publication The Alibi would be loathe to spew the same old same old garbage you can read anywhere. The fact that you think this crap is worth publishing explains perfectly why I keep my diagnosis a secret.

Hi Cranky,

I understand why you take this article personally and interpret what I'm saying as a regurgitation of the stigma you so often suffer in association with your disease. But it's not intended, nor written, as an attack on people with diabetes. Remember this paragraph?

"Not everyone who has the disease is overweight or sedentary. The last guy I took care of with type 2 diabetes was probably 125 pounds dripping wet. Certain minority groups are more likely to get the disease, even when matched for weight and age to their Caucasian counterparts. Minorities also tend to develop a more aggressive form of the disease. Add this to the fact that minorities are less likely to have access to insurance and health care, and you’ve got a recipe for disaster."

Nor do I suggest that the solution to diabetes lies in "faulting" any "fat lazy pigs":

"Clearly, diabetes is a public health issue that raises more questions than answers. This is not just about people drinking too many sodas and watching too much television. This disease is steeped in cultural and economic factors like poverty, education, family structure, employment opportunities and access to care. It’s easy to tell people to diet and exercise. It’s hard to create an environment in which people actually have the knowledge, motivation, and social and financial resources to make it happen."

I know you feel that I, by restating the fact that diabetes is almost completely preventable, am reinforcing a stereotype. But I'm discussing a fact, not some opinion of mine. From the CDC's 2007 National Diabetes Fact Sheet:

"Progression to diabetes among those with prediabetes is not inevitable. Studies have shown that people with prediabetes who lose weight and increase their physical activity can prevent or delay diabetes and return their blood glucose levels to normal.

• The Diabetes Prevention Program, a large prevention study of people at high risk for diabetes, showed that lifestyle intervention reduced developing diabetes by 58% during a 3-year period. The reduction was even greater, 71%, among adults aged 60 years or older.

• Interventions to prevent or delay type 2 diabetes in individuals with prediabetes can be feasible and cost-effective. Research has found that lifestyle interventions are more cost-effective than medications."

This prevention is what I'm talking about when I say we must make the necessary changes, and nowhere do I say the burden of change rests on the shoulders of those with the disease. I argue it must be a society-wide effort.

I know it's enraging to have a disease that people perceive as "your fault." It wasn't my intention to echo that sentiment here (nor do I think I do). But it's also not my intention to sugarcoat the strong associations between diabetes 2, weight, and lifestyle. Nor is there any point in sugarcoating the devastating consequences of diabetes. Many people without diabetes don't understand the fact that people can lose vision, or limbs, or kidneys, or quality of life, just from having high blood sugar. Would we let people lose vision, and kidneys, and limbs from Ebola, or would we organize quickly and efficiently to stop it? So why aren't we doing the same for diabetes? The strong language and comparison to diseases like Ebola clearly serves the purpose of illustrating how we, as a society, should think of diabetes and our response to it the same way we think of responding to more "attention-grabbing" diseases like Ebola. The point clearly isn't to say, as you suggest, "you're going to die a horrible death and it's all your fault." My suggestion throughout the article is society-wide prevention, not individual changes.

"Diabetes won't abdicate its destructive throne on its own. We, as a society, must empower one another to make the necessary changes. So our first challenge, as we move into a future in which one in three Americans could develop diabetes, is to make this real to people."

Anyhow, I apologize that this article rubbed you the wrong way. This wouldn't be my approach with a patient of mine. But this article wasn't written for patients. It was written for the 24 year old Alibi reader who usually skips to the music section and isn't thinking about tomorrow and doesn't give a damn about this disease. Like I said, my goal was to "make this real to people," not offer a management plan for victims of the disease.

Thank you for your thoughts. I will consider them the next time I'm writing about a disease with a stigma or stereotype attached to it. It's always important to be reminded of how people who actually suffer from a particular condition perceive what's being tossed around in the media.

Interesting comment from a cranky Diabetic....Bravo to Ms. Doyle for her excellent fact-based retort on this disease. Although there is a genetic component to the disease it DOES NOT completely dictate if one will have Diabetes. The problem is that lifestyles have made it much easier for Diabetes to manifest itself in a genetically susceptible person. If it were soley genetics, then why have the rates gone up and are expected to triple by 2050?? Why are children now having hypertension and DiabetesType 2 at younger ages?