Monday, November 08, 2010

Most Americans Don't Know $#!t About Diabetes

With a title like this, I hope to attract some readership out of sheer curiosity!

Let's begin by noting that November 14, 2010 is World Diabetes Day. This is the first-ever day designated by the United Nations and World Health Organization for non-communicable diseases. President Obama has issued a proclamation declaring November 2010 to be National Diabetes Month. No doubt, there will be a lot of press about diabetes in the coming days, and much of the coverage will focus on how much of a drain on limited healthcare dollars these diseases are or how horrible the consequences of diabetes can be. Unfortunately, much of this will be bad reporting, which conveniently omits key facts to fit a story in someplace.

Let's begin with the basics: most of what the average person THINKS they know about diabetes is just plain wrong -- that's a sad but true fact. You may note that in the paragraph preceding this one, I used the plural term "diseases" to describe diabetes. That's because diabetes, contrary to popular belief, is not a single disease, and no one fact applies to every person living with diabetes.

Facts back this assertion up. Back in 2007, medical device manufacturer Medtronic commissioned a survey (see HERE for more) conducted by Harris Interactive of 2,436 American adults which found that 80% of the American public could not even distinguish between type 1 and type 2 diabetes. Even more troubling was the finding that nearly 70% (67% to be exact) of those who responded to the poll incorrectly believed there was already a cure for type 1 diabetes (there isn't). Other troubling findings were as follows:

While more than half 51% knew there were two types of diabetes, more than a third (36%) also believed there was either a "type 3 or 4" diabetes (there aren't). This is indicative of just how little knowledge most Americans really have about diabetes.

One-third (32%) believed exercise could be a "cure" and one-fourth (25%) believed that proper diet could "cure" the disease. Neither is a true.

True, diabetes does have something to do with blood glucose levels (sometimes mistakenly referred to as blood sugars, including by many doctors who try to use terms that are easy to understand), but the disease rarely has anything to do with with cane sugar. Intrigued? Good -- please keep reading!

The fact is that most foods humans eat are eventually metabolized into a basic fuel used by the cells called glucose, but those aren't nececessarily sweets. Even proteins like meats will eventually be converted into glucose because that's the only fuel that cells can use. So the next time you're trying to feign concern by giving a person with diabetes some God-awful "sugar-free" stuff, realize that those things aren't necessarily any better (or worse) than the real thing may be, especially since that stuff also may cut the sugar, but many load up on fat, salt and other dietary taboos in place of sugar.

When blood glucose levels stay high consistently, that's indicative of diabetes. But even people who do not have diabetes will have "high" blood glucose levels immediately after eating, especially if they've eaten a highly-processed food that's loaded with carbohydrates.

But beyond this, there are far too many misperceptions about diabetes.

One is that diabetes is related to obesity. The fact is that many people with diabetes are normal weight or thin, and people diagnosed with type 1 diabetes usually loose a lot of weight prior to being diagnosed. Type 1 diabetes is an autoimmune disease where the body's immune system makes a mistake and attacks and destroys the cells that produce a hormone called insulin which exists in all human beings (except those with type 1 and some with type 2 diabetes). No amount of diet alteration or exercise will prevent type 1 diabetes from occurring. This is a fact that many editors are quick to omit to save space.

Also, contrary to what most articles routinely report, obesity does not CAUSE cause type 2 diabetes, but obesity IS actually one way the body protects the body from the ill-effects of type 2 diabetes. True, people who are overweight can sometimes prevent themselves from ever developing type 2 diabetes by losing weight, but realize that the diabetes happens first, not the weight gain, and the disease makes it much more difficult to loose the extra pounds, plus many medications to treat diabetes often make weight-loss even more difficult.

Finally, well-managed diabetes almost never causes blindness, kidney failure or heart disease. Only poorly managed diabetes (either type) causes these things, but managing diabetes is an incredibly complex task that requires a lifetime of commitment. It CAN be done, and people who do so often lead fulfulling lives, but doing so is no small task and should not be treated so casually. It's a marathon, not a sprint.

Now that I've teased you with the real facts, I hope you will decide to learn more about what is arguably a complex group of diseaseS. The reality is that diabetes is incredibly complex that most doctors spend many years, and a short article is usually not enough information. The average person cannot possibly know all there is to know, and you aren't expected to.

But ... you are also expected not to start blabbering like you do know something about the disease when you really do not. When you don't know something, it's always better to ask questions rather than blurting out unsolicited advice proving how stupid you are about the subject -- that's just plain rude. To help you out with this, the Behavioral Diabetes Institute has created some handy etiquette cards for people who do NOT have diabetes. Download one for yourself HERE and read it before saying something stupid.


Virtue said...

Thanks, Scott. Great write-up :)

Jacquie said...

All of my coworkers are probably wondering why I just stood up and clapped for 86 seconds straight.

Thanks for this!

Bennet said...

Hell I don't know $#!t About the Diabetes-es and I figure I know a lot more $#!t them than most folks. That is exactly why I read what your posts my friend. To know $#!t.

Liz said...

Well done! What a great, great article! :)

jpnairn said...

A good site for Type 1 diabetics to educate others is:

Actually, a lot of stuff there applies also to type 2.

The poor diabetic said...

Well put as usual Scott, the sh%t most people don't know about diabetes could fill the grand canyon twice hopefully that the message we should be passing along in this diabetes awareness month.

Jenny said...

You left out one of the most annoying oft-repeated pieces of misinformation, that I just today saw in a press release on Science Daily, the idea that "people with Type 2 diabetes produce lots of insulin, but their diabetes is caused by insulin resistance."

Genetic studies and studies with insulin clamp testing routinely reveal that people with Type 2 diabetes often have defects of insulin secretion and dead beta cells. By the time a person is diagnosed with Type 2 diabetes, as much as 80% of their beta cells may be dead.

People with Type 2 usually (but not always) are insulin resistant, but so is 2/3rds of the adult U.S. population. Only about 10% of the population develops Type 2 diabetes.

And most importantly, people who are insulin resistant cannot eliminate their insulin resistance through diet, exercise or drug treatment. They can normalize their blood sugars and avoid complications, but the underlying insulin resistance remains.

Andrea Wrape said...

Thanks for the article!! PS: I love the Diabetes Etiquette form. Why didn't I have this 19 yrs ago when I was diagnosed to hand out to my family!!

Allison Blass said...

Standing ovation, my friend, standing ovation!

kelly close said...

Way to say it, guy ... thank you (again)! Best kelly