Great. So now my dentist is going to tell me how to control my diabetes?

I was diagnosed with diabetes a little over a year ago.  I had moved to Austin, Texas, not too long before my diagnosis and I moved to Seattle about two months afterward.  Needless to say, there were a few transitions taking place during the already transitional time of my mid- to late-twenties.  One of my first nights in Seattle, I sat down to make a list of various doctors and specialists I needed to visit.  I arranged the seven doctors in order of priority from most integral to my health (endocrinologist) to least (allergist) and set my mind to scheduling visits with each of them.  I am proud to report that, over a year later, I am finally getting to Number Two.  (Hey!  Didn’t you read the part about the transitions?  Life as a 28-year-old can be tough, ok?!)

When I went to my endocrinologist, he told me to be sure to follow up with my dentist to be on the look-out for various concerns that can occur more commonly in people with Type I.  So, this evening, at the end of my cleaning and x-rays, I told the dentist that I had diabetes and wanted to be sure that I was doing everything necessary to prevent whatever often plagues people with diabetes (I’m still not sure I understand what these things are, but please feel free to leave a comment and help a sister out).  My dentist then launched into how “strange” it was that I was diagnosed at age 27.  “You’re sure you have Type One?”  I don’t know how I kept from rolling my eyes.  “Great,” I thought, “here we go.”  He said that I had to be sure to monitor my blood glucose levels.  “I mean, you know, make sure you’re going in for your tests and make sure you keep your numbers good.”  I was beginning to think he had no idea what diabetes was and was just reciting some generic “be careful”-type speech, until he said, “As long as you keep your A1C at 6.0 on the dot, you’ll be fine.”  Oh, really?  That’s all it takes? I could feel the defensiveness rising in my throat as I stared at him.  Is my dentist now advising me on my diabetes care? I calmed myself down and tried to assume best intentions.  He probably knows people with Type I.  He probably sees people with diabetes who don’t take care of themselves.  He’s just responding to my statement.  This is totally appropriate.

I left his office, though, and all I could think about was wanting to talk with you–my diabetes community–about this experience.  While I do assume his best intentions and recognize that I was the one who initiated the conversation, I can name the fact that it never feels good to have someone tell you how to manage your diabetes.  I have a close relationship with my endocrinologist and I sometimes feel defensive even when listening to his advice–and that’s his job!  The defining difference?  He doesn’t have Type I.  As much as I work to remind myself that people without diabetes have very useful information and helpful insights, there is a line drawn at a certain point in the conversation.  This point is usually when terms like ‘just’ or ‘be sure to’ are thrown into the dialogue.  If that’s how it’s going to be, then you better look out because I’m not cutting anyone a break.  In my reflections this evening, I started to think that this was a double-standard I was imposing on my non-diabetic peers, but I quickly realized that I have not (yet) come across people with Type I who use those terms or who try to tell me how to manage my diabetes care.  Of course we offer each other examples and stories of how we have each responded to various concerns we’ve had, and of course we volunteer our input when asked about a specific question, but I couldn’t ever see myself turning to my friends with diabetes and saying, “Just keep your A1C at 6.0 on the dot and you’ll be fine.”

It just isn’t that simple.

Maybe it’s because I spent all of last night and today in airports.  Maybe it’s because he had just stabbed that pointy thing into my gums.  Maybe it’s because I enjoyed a supportive community of family all weekend and had grown accustomed to their genuine understanding of my approach to diabetes.  Whatever the cause, he crossed me.  I looked at him and said, politely, “My endocrinologist helps me monitor all of the stuff going on with my blood and my body, but if you could just help me look out for warning signs in my mouth, that would be great.”  Both the dentist and the dental hygienist were very receptive to this and thanked me for informing them of my concern.

I’ll let you know how things go in six months.  There may be yet another opportunity for education at my next appointment.

Emily Patton

Emily Patton is one of those not-diagnosed-until-age-27 people with Type I. She is currently living in Seattle, Washington, where she admires Mt. Rainier from her car window during daily commutes. She grew up in Columbus, Ohio, but has since lived in Berkeley, California, Austin, Texas, and even served short stints in a small village in the Cascade Mountains.