Laying Blame: Why Do People Get Diabetes?

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Why do people get diabetes? People get diabetes because they’re fat. They get diabetes because they don’t exercise. They get it because they’re lazy and they lack discipline in controlling their appetites. They get diabetes because they’re out of shape slobs. People get diabetes because they deserve it.

Most people won’t say this to your face, but that doesn’t mean they’re not thinking it. The extent to which people believe that diabetes is the fault of the diabetic became very apparent, recently, after a finger pointing exchange about blame for the condition by two celebrity chefs. And what that reveals is an underlying societal discrimination of diabetics that could cost people their lives.

In January celebrity chef Paula Deen revealed she had type 2 diabetes. The creator of a hamburger featuring doughnuts in place of a bun was met with a backlash of blame. She was drawn into a kafuffle with fellow celeb chef Anthony Bourdain when he said he thought it was in “bad taste” for Deen to be dishing high fat Southern cuisine while she had diabetes and had not told the public about her condition. The implication was that Deen’s recipe for loaded mashed potatoes was the food equivalent of a loaded gun because, clearly, eating such rich foods leads inevitably to diabetes.

“People out there with diabetes haven’t chosen this,” Deen said in response to Bourdain’s comment. “It’s not their fault. So many things play into whether or not you get diabetes. I thought [what Bourdain said] was very, very cruel.” (prevention.com)

And that’s when it got ugly. That was when people stepped up and, from behind their anonymous postings on blogs and Internet sites, laid the blame where they believe the blame belongs.

“Look people, there are consequences for what you put in your body,” an anonymous poster wrote on thestir.com in response to an article about Deen and how much responsibility she should shoulder for her condition. “This isn’t some autoimmune disease. It won’t ‘just happen no matter what you do.” If you are taking dietary and/or health advice from a woman who ate herself into obesity, you deserve what you get.”

There’s that word: deserve. The “they deserve it” argument isn’t new to healthcare. People who smoke cigarettes deserve to get lung cancer. Gay men who engage in unprotected sex deserve to get AIDS. Overweight people deserve to suffer heart attacks. The “they deserve it” argument, however, is more than just an opinion about Old Testament retribution for lifestyle choices.

In the cases of AIDS, lung cancer, and heart disease, more people died and got sick than otherwise might have because the idea that they deserved to be sick was accepted on a mass scale. That institutionalized belief in blame restricted funding, which hampered research, which, in turn, cost lives.

As an example, President Ronald Reagan spoke about AIDS for the first time in 1987, more than six years after the virus was first identified. Between 1981 and 1987 almost 60,000 people had acquired the virus, and almost 28,000 had died. If Reagan had made a speech about the need for AIDS research and treatment in 1982, how many people’s lives may have been significantly extended through research into creating more effective medications?

With diabetes, we’re in 1981. Paula Deen helps provide another example of how thoroughly accepted it is to casually blame diabetics for their diabetes. When Deen was poised to reveal she had diabetes, ABC News previewed her announcement in a story called: “Paula Deen to Confess She Has Type 2 Diabetes.”

Confess? Don’t people typically “confess” to something they’re guilty of, something they’re to blame for?

While it might seem silly to think the name of an ABC News story is a cultural bellwether, it’s not once you look at some numbers that are representative of overall research spending. In 2006, according to the New York Times, the United States government spent ten times more, per patient, researching cancer than researching diabetes. This despite the fact that the number of people with diabetes is on the rise, while the number of cancer patients is falling.

One way to explain that disparity is that most people simply don’t believe diabetics deserve more investment in a cure. After all, they’re already getting what they deserve.

For more from Alex O’Meara see his essay Curing Diabetes: Would I Do It Again?

Alex O’Meara is the author of the book, Chasing Medical Miracles: The Promise and Perils of Clinical Trials. For more about Alex visit alexomeara.com. For further reading on clinical trials in general and on diabetes.

Alex O’Meara is a regular contributor to ASweetLife, he writes the blog The Other Side of Diabetes.


see:http://online.wsj.com/article/SB124718276289720211.html.

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Comments (22)

  1. Diane Cohen at

    I wish you had differentiated between type 1 and type 2

  2. Michael Aviad at

    As a person with type 1 diabetes I’ve been told many times “but you aren’t fat” or “did you eat a lot of XXX”. It’s true that type 1s are blamed less for their condition but it still happens all the time.

  3. No one deserves to get diabetes – Type 1 or Type 2.  I have Type 1, but my Type 2 friends should not be blamed for their diabetes any more than I should be blamed for mine.  None of us chose this, and all of us deserve a cure.

  4. Cathy at

    Wow – what an article. It is my biggest fear that THIS is why funding and support for type 1 diabetes is lacking. The stigma attached to the word “diabetes” means that so many people think that my daughter has type 1 because I “fed her too many sweets” or because I am overweight. Seriously, when are we as a human race going to stop pointing the finger at others?

  5. Lisa at

    I am SO TIRED of people being obsessed with the difference between Type 1 and Type 2.  I am a Type 1, and I know plenty of both types, and let me tell you no one has it “easy”.  We all suffer, overcome, battle and celebrate because of and in spite of this disease.  No one squabbles or compares what type of cancer they have.  Instead of getting bogged down with labels we should focus on coming together as a group of people, supporting each other as we strive to win the fight over diabetes.
     
    Fantastic article, loved it.

  6. Jennifer Jacobs
    Jen at

    Excellent post. Just makes me want to go rghhhhhh…!!! 

  7. Karmel Allison
    Karmel Allison at

    So the interesting question this raises is: if diabetics “deserve” what they get, does America deserve the massive health care problem we’re going to have over the next fifty years as predicted by the CDC? I wonder where we’ll start pointing the finger if the number of diabetics surpasses 50% of Americans. At that point, is it really safe to assume the majority of people are individually making the same bad decisions? The reasonable thing to do seems to be to suspect a more endemic problem. I think your example of Ronny Ray-gun and AIDS brings up a crucial point, too: regardless of where the blame lies, we’re going to need to deal with this problem, and the sooner we start, the better.

    Thanks for a provoking piece! 

  8. The idea that Type 2 diabetics “deserve” what they got is rooted in ignorance and willful refusal to consider the known facts about the disease. Before we get increased funding for research into Type 2, we need the media to present the correct interpretation of the facts, including genetic vulnerability, societal pressure, and market forces. For starters, they need to acknowledge that obesity does NOT cause Type 2 — otherwise, why would 25% of the population be obese without ever getting diabetes? Obesity is a disease in its own right, and needs research dollars as well, but diabetes is a spectrum, and Type 2 simply cannot be characterized as “she got fat, and therefore got diabetes.” More research will surely show that Type 2 diabetes is a collection of diseases and treatments need to be tailored to the individual, because individuals differ. I don’t think I’m going to see fair treatment for Type 2 diabetics OR obese people in my lifetime, but I can hope!

  9. zack at

    Anthony Bourdain’s comment wasn’t that she deserved it. It was that here she was with a preventable disease selling other people on the same food that gave it to her for 3 years. It’s knowingly passing on bad information to unsuspecting people. It’s irresponsible and wrong.

  10. carl at

    zack it is your thinking that perpectuates the stigma that type 2 diabetes carries. You need to be educated.

  11. Wow — a provocative (and useful!) piece. Some of the more interesting sessions from the ADA Scientific Sessions this week were about epigenetics, and how your genes (and likelihood for type 2) can be affected by the nutritional status/health of not just your mother (while she was pregnant with you), but the parents of both your mother and your father (i.e. your grandparents). It’s very easy to point fingers, but in the case of Type 2 diabetes it seems that rather than assigning blame, we should be working together on prevention and treatment. There are just too many variables at play. 

  12. Katy at

    Wow. I can’t believe people think like this. I mean, yes, being healthy is important and can help prevent type 2, but plenty of people will get it anyway! And then type 1. I am shocked how many people think I caused my type 1! The two should have different names or something… Don’t get it wrong I’m not against type 2s, and plenty do eat healthy, or try! So the stereotypes are from the few that don’t take care of themselves. Wow. Really Mature. I think we need a cure for both types, and definetly more awareness. Thanks for this article :)

  13. KIMBERLY at

    WHAT ABOUT BABIES THAT ARE BORN WITH TYPE 1 DIABETES? ARE THEY GETTING WHAT THEY DESERVE? TYPE 1 DIABETES HAS NOTHING TO DO WITH WEIGHT OR EXERCISING. MY SON WAS DIAGNOSED WHEN HE WAS 9 YEARS OLD, AND LET ME TELL YOU, DIABETES 1 IS NOT PREJUDICE. IT DOESN’T CARE WHAT COLOR YOU ARE, WEIGHT, AGE, OR WHAT YOUR FINANCIAL STATUS IS. I THINK THAT IGNORANT PEOPLE GET WHAT THEY DESERVE. GET EDUCATED, AND REMEMBER TYPE 1 DIABETES CAN ALWAYS GET YOU OR SOMEONE YOU LOVE.

  14. Tim at

    With the stress the average American diet puts on everybody’s body, it’s a miracle anyone can be “skinny” in this society. The availability of cheap, processed foods, aided and abetted by our government and the food & beverage industries has led to a diet too rich in carbs. Type 2 diabetes MAY be avoidable, but that does not mean it always is.

    The big problem that I had is that Paula Deen seemed to wait about her announcement until she had a drug endorsement deal. I don’t blame her for developing Type 2 diabetes, but it APPEARED that her only motivation for making it public was to benefit monetarily. Her decision not to change her recipes to reflect her health reality seemed to be based on the fear that changing her recipes would affect her ratings. That has nothing to do with blaming her for developing D. I thought when I read about it, “not helpful to the diabetic community.” (I am LADA, diagnosed 3 years ago at 43).

  15. Lisa at

    ummm….I hate to burst your bubble Lisa, not that it’s a squabble but in a support group for breast cancer, the stage 1’s will be afraid of the stage 3+’s because there before the grace of God they go. And stage 3+’s will think “Quit whining, you got off without chemo and a mastectomy, there is a 98% chance that your cancer will never return, why are you even here?” Let me tell you, we all have to watch our diet and exercise, but I think I’m the stage 1 of this disease. While sometimes I’d like to bolus and eat what ever I want, I understand that it is harder to control this disease when your pancreas doesn’t produce any insulin. You have my respect and sometimes my envy. But at the end of the day, I’ll meet you in the gym.

  16. Libby at

    I am a Type 2 diabetic and I do not feel that I deserve to be diabetic. I have a genetic disposition for diabetes on my Mother’s side of the family. There are 4 to 5 generations of diabetes in her family. So do I deserve to be diabetic?

  17. JustAnother at

    As a Type 1, my feeling is that there really isn’t much benefit to combining the two, very different diseases, as one. Paula Deen’s disease has nothing to do with mine. They have 2 different causes, mainly 2 different paths of treatment and even though the ADA combines the two as one for fund raising purposes, neither has a cure. Both are able to be turned down for coverage by insurance companies. Both illicit unwelcome comments from the ignorant general population. The only difference I see is that Type 2s have more avenues of treatment than Type 1s. I will never be able to get rid of all symptoms of my disease through diet and exercise, ever. Bourdain, while obnoxious and self serving, does make some good points, but everyone has to make a living. Then again, maybe ‘former’ heroin addicts shouldn’t throw stones.

  18. GreyBee at

    “Just another”, you are not right that Type 2 has nothing to do with Type 1. As my top notch endocrinologist has put it, in a Type 1, the pancreas doesn’t make insulin. In a Type 2, the pancreas often makes too little insulin. In addition, many Type 2 diabetics are insulin resistant, which means that no matter how much insulin there is, the body’s cells are not receptive. That means the cells do not get energy and blood sugar builds up in our system. My endocrinologist is a more recent graduate and up on all the latest research and said that Type 2 may be more complex than Type 1. Not all Type 2’s are the same, and it is created by multiple systems in the body. However, like Type 1, genetics are the culprit, because if obesity and eating badly were the culprit, all obese people or those with poor diet would be diabetic. I have struggled with multiple chronic illnesses that often have conflicting treatments, and been judged terribly without anyone having a clue how hard I fight to control them. My father is nearly 80, obese, eats beyond poorly and his blood sugar is fine. I can’t stand that I feel like even Type 1 diabetics think that they are victims of an autoimmune disease and Type 2 diabetics victimized themselves. That said, I think that no one was thinking that Paula Deen deserved to have diabetes, but criticized her for promoting and validating food choices that should never have been promoted. Let alone that she was reinforcing a negative stereotype that this is how Type 2 diabetics eat, and the inference that if she ate like this, that is why she has it. You didn’t have to wonder why she kept her diabetes a secret. She knew she was promoting and validating an extremely unhealthy lifestyle, and that you can’t or shouldn’t  validate eating like this if you are diabetic. It negates the idea that eating like this is OK. She clearly hid her condition b/c she was making money promoting unhealthy eating. And people wanted to hear that eating like this was OK and part of what makes life worth living. Yet I think there are many Type 2 diabetics that know that eating like that is wrong. What people don’t see is that insulin makes it nearly impossible to lose weight. And that people often have episodes of hypoglycemia and then overeat b/c they feel sick. If they have another illness that causes a lot of pain, it may make it difficult or impossible to exercise at times. That there are times that people are controlling it well, and some times that it is not going well. It is hard to fight this all the time and still find my sugar out of control. My medication for another condition increases insulin resistance, and ever since then it has been an uphill battle. Never needed insulin before, and am on a no-carb diet. Still out of control at times. It can be depressing.  I know taking lots of pills and insulin is not fun and something I did to myself, or would wish on my worst enemy.  I always do my best, but still I get judged. I don’t get asked about my situation. It is just assumed that because I am overweight, then I am eating cake & ho-ho’s. I have no restraint. I am a glutton. Fat = eating too much. I often eat like a bird. The bottom line is that people need to stop making assumptions and judgments. I may be fat. That may be my body type right now. But I am a person, who can be kind, funny, smart, spiritual, educated, musical, thrifty, who writes and paints, loves cats, loves nature walks. But all you see is my weight, and make assumptions and judgements. You are not entitled to do that. And I can make a judgment of my own. That there is in fact a problem, and it resides in your own heart. I can only assume that those that judge us are in fact unhappy in themselves. I know for a fact that means I will always be happier than you, because I accept myself completely. And I believe I deserve (yes, deserve!) respect and love, simply because I am a good human being. So, to all those who are ignorant, I hope this edifies you; to all those who have felt this way: you are not alone. Take pride in knowing how much you deal with every day, and that it really is what is on the inside that counts.

  19. kristin at

    I have had diabetes since I was 9 years old. I’m now 27 years old. When my family and I found out we were told that I didn’t do anything wrong to get it.

  20. JR at

    Of course no one deserves diabetes. It would be awful form to wish that upon another. That said, living an unhealthy lifestyle with little exercise and lots of sugary foods is inviting diabetes into your body. There is no way to protect yourself 100 percent no matter how healthy you live, but I find it hard to sympathize with overweight people and the bevy of health problems that leaves them at risk for.  Go for walks, see a dietician. You will live better, and hopefully longer. 

  21. joel crawford at

    Hi all I have type 2. This email I send out to all those ignorant people out there who play the blame game and do not know the facts. I am a 33 year old man who also has arthritis problems’ and I have Epilepsy on top.

    Throughout my teens and 20s I was a very active person on a very healthy non fat or sugar diet. I have won many sporting awards, comps, tournaments and have represented at state and international level. at one stage between 19 – 25 I never had take away, touch booze or drank coffee or pop. I just drank lots of water and drank green tea, white tea, and black tea without! without sugar. From 2001 – 2008 I even stopped using milk in black tea and went soy.

    I have also at times in my life cut out meat, and just ate high in omega 3 and 6 fish and have always done the take 5 – 6 fruit veg thing a day. I used to get up every morning summer, winter or rain and go for a 5am run every day. I also work in the sport & Rec area and have accreditations in fitness, Coaching, Sports Psychology and Sports Medicine.

    I throughout my teens and 20s used the gym 5 times a week! did all the fitness stuff and played much competitive sport such as squash and Tennis. As I also have Epilepsy I do not drive! so I ride my bike all over the place.

    My only let down was when I got Arthritis at age 30 and I got it in my ankle’s! which had me getting around not playing sport on crutches and a walking stick for two years. I ended up slapping’ on a great load of fat!! which I’m still working off. Because of this laps I ended up with type 2 in March 2012. I am now on Diabex medication and still living the healthy life stile I always have! Even the doctors and health pros’ keep congratulating me on what I am doing!. So I should there was a time when I used to help people get fit and lose the fat.

    Though due to my many health issues’ I can not do half of what I used to. I am the night coordinator and court supervisor of a Basketball association, I Coach junior Basketball! I still ride my bike all over the place! have my own gym! I use about 4 times a week, I play in Tennis comps’ when my arthritis is not playing up! and I like to go on long walks to freshen up the mind. I also still eat lots of fruit and Veg, eat fish and in general have a health diet.

    So do I sound like a bloke who has been a couch potato, eating all manner of rubbish food! no exercise and deserves to have diabetes???.
    Truth of the matter people, like Cancer, people in general need to find out more about their own family’s past illnesses!. I have found so far who are still alive on my father’s side 4 with type 2 and 3 with type 1!. Think this may have more to do with it! in my case! than life style! as I have always lived a healthy life style! and still do!. It still did not stop me from like others in my family ending up with this bad illness at only the age of 32. Funny enough I never used to like sweet things’ and never would take sugar unless drained from physical exercise. I now find my self needing to take sugar because I’m always active and often drop too low to the danger point.

    So to those foolish people out there who blame every single diabetic out there for bad life style!!. Just remember my case! and please think before you blame. As those that do! know very little.

  22. David at

    I’m 380lbs I drink more than 5 cans of soda daily and never go outside for any reason. I eat junk food more than anything else. I’m in my thirties. I’ve lived this lifestyle since I was born. I’m nowhere close to having diabetes and that makes me suspicious. If what everyone says is true how can a kid have diabetes but I can live all the way up to my adult life without a hint of problems.

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