That Which We Call Diabetes…

What’s in a name? That which we call diabetes
By any other name would smell as sweet.

I’m a little late weighing in on the Chicago Tribune article, Diabetes’ Civil War.  But now that I’m here talking about it, I’m going to be honest and say that I didn’t like the article.

First of all, getting annoyed at people who don’t understand the difference between type 1 and type 2 is pointless.  I get annoyed sometimes, too.  But really- it’s wasted energy.  What type 1’s should do is use the strength and knowledge they have acquired managing type 1 diabetes to teach what they know to type 2’s and to everyone else.  Instead of being angry, let’s try to get type 2’s and the general population to understand what carbohydrates are.  Most people don’t understand that the rice they eat at dinner acts no differently in their blood than the sugar in their dessert.

Second of all, the idea of changing the name of type 1 makes no sense because type 1 is not really a different disease.  There is a long spectrum of diabetes with type 1 in children at one end and obese type 2 adults at the other.  And I, with a LADA diagnosis, land about halfway between them.   For anyone who is really interested in this subject, I recommend the article: Declassifying Diabetes, by E.A.M. Gale. See quote below:

“Meanwhile, our understanding of the involvement of immune processes in the causation of diabetes remains limited. We do not know whether disordered immune function is the cause, precondition or consequence of beta cell damage. Our notion of type 1 diabetes is based around a pathological lesion that cannot be measured in life, and a sequence of immunopathological events described mainly in the mouse. The concept of autoimmunity, in other words, is valuable in certain contexts but does not provide a secure, easily measurable, or consistently useful means of dichotomising diabetes. A further limitation is that this mindset traps us into the assumption that immune processes are either totally responsible for the development of diabetes or not at all, excluding the more realistic possibility that both immune-mediated and non-immunemediated processes might act in synergy, especially in later onset cases.”

There are still so many holes and unknowns in the science of diabetes.  And what really matters most for everyone is not calling it this or that, but making sure patients get the correct clinical treatment, learn to eat right, exercise, and manage diabetes.

Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and has continued to write essays and fiction while raising her three sons (and many pets).

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Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and continues to write essays and fiction while raising her three sons (and many pets). Jessica’s work has appeared in The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review, Tablet Magazine, and elsewhere. She is the diabetes correspondent for The Faster Times. In 2009 she and her husband, both type 1 diabetics, founded A Sweet Life, where she serves as editor-in-chief. Jessica loves spending time with her sons, cooking with her husband, playing with her cats, reading, biking, drinking coffee, and whenever possible, taking a nap. Follow Jessica on Twitter (@jessapple)