Sunday, May 15, 2011

Diabetes Blog Week Day 7: What We've Learned

Like some of my d-blogger peers (I'm thinking of Cara at Every Day Every Hour Every Minute, today's last Diabetes Blog Week post is going to be short & sweet.

This 7th post: What We've Learned. Last year, one d-blogger made a suggestion for this topic. She commented that "Day 7 should be a post about stuff we've learned from other blogs or the experience of coming together online..." So today, let's do just that! We're writing about what we've learned from other blogs, this week or in full since finding the DOC. What's the experience of blogging been like, and what's the DOC done for you? This post could even be used to look ahead and talk about what the future holds.

This post is supposed to be about what I've learned. Basically I've learned one very important thing about myself & my diabetes since I found the D-OC. That is that I am NOT ALONE! Beyond that, I've learned that there are so many creative, interesting and dynamic Diabetes Blogs out there and their numbers continue to grow! Neither is a small discovery!

Well, that's all for today. More to come after I've managed to digest all of the posts from this past week!

Saturday, May 14, 2011

Diabetes Blog Week Day 6: Saturday Snapshots

As a participant in Diabetes Blog Week, today's topic is Saturday Snapshots (meaning photos). This is a topic that was brought back from last year. Inspired by the Diabetes 365 project, this idea is to snap a few more d-related pictures and share them again. We can post as many or as few as we'd like. Be creative! Feel free to blog your thoughts on or explanations of your pictures. Or leave out the written words and let the pictures speak for themselves.

I'm not a huge fan of photos of myself (I hate having my picture taken, and no picture of me ever looks good in my opinion), so this is one of those occasions where I thought it best to share some miscellaneous diabetes-related photos that I think may look familiar to a few people in the diabetes online community (don't worry, I'll include some captions, but sorry about any red-eye, I didn't have time to try and fix that). Over the years, some of the greatest events have been face-to-face meetups, summits and other get-togethers with fellow diabetes bloggers. Here are a few I had handy:

In Front of the Capital at the ADA Call to Congress, 2006

Photos of My Sister's and Mine, CWD Quilt for Life (At Home)

A photo from the DRI Diabetes 2.0 Summit in NYC in Fall 2008

Another Diabetes 2.0 Summit, This One in Miami, Fall 2009

Another Diabetes 2.0 Photo from 2009, I'm the Guy on the Right!

Me and Ninjabetic at Roche Summit-Orlando 2010

Dinner at Medtronic Summit, Los Angeles, March-April 2011

After Medtronic, I Went to Hollywood hills for a Photo Shoot!

Friday, May 13, 2011

D-Myths (D-Blog Week, Day 5): What I'll Be Doing Post-Cure

Today's topic for Diabetes Blog Week is Awesome Things Friday (see HERE for more). In February the #dsma blog carnival challenged us to write about the most awesome thing we'd done DESPITE diabetes. The topic challenges us to today, so we've been asked to put a twist on that topic and focus on the good things diabetes has brought us. What awesome thing have you (or your child) done BECAUSE of diabetes? After all, like Karen's blog header says, life with diabetes isn't all bad! (Catch my Diabetes Blog Week posts from Day 1, Day 2 and Day 3, and Day 4).

I just don't have it in me after a long week of work to approach that topic on a Friday night. Instead, today, I've decided to use one of the "wild card" topics, because even though I hate to say it, some of them are starting to sound a little on the repetitive side (I've got to call them like I see them). Besides I don't really think of anything I do in spite of diabetes as particularly awesome, because I don't really recall much of life before this disease. I remember bits & pieces, but the reality is that was 35 years ago and I was just a kid of 7 years old at the time.

The wildcard topic I'm going to go with: Let's PROVE some fun d-myths like #dprom (the prom for diabetics around the world), Sprinkles (the glittery unicorn of advocacy), or Blünt Lancet (the diabetic heroes of rock)! Choose one of these "d-myths" (or create one yourself) and take it someplace creative! Write about any "myth" or story-line you can dream up! Let's bring those "myths" to life!

Now, I've spent a fair amount of my blog content proving that there WILL actually be a cure for type 1 diabetes (someday), and providing evidence of progress being made towards that objective (see HERE and HERE for two such examples), even if it may be unaffordable if and when it does arrive. I really DO believe it will actually happen (someday), but I'm no longer convinced it will necessarily happen in my lifetime. The reason: I am 42 years old, and have spent 35 years of my life (or 83% of my life) living with type 1 diabetes. The odds are (and time) is kind of working against me.

But ... suppose all the cards did work out right, and one of the autoimmunity treatments JDRF investigated which failed today were re-examined, leading to a stunningly simple, inexpensive treatment for the autoimmune response that causes type 1 diabetes. With that major problem solved, a number of different regeneration and/or transplantation treatments would restore us to euglycemia for the rest of our lives, without ongoing treatments, costs or refreshers.

My D-Life, Post-D

What will I pursue? What will happen to the Diabetes Online Community that has brought so much joy to so many people living with diabetes? Damn good question!

First, let's note that I might be cured, but many people in the U.S. (and elsewhere in the world) will still suffer from type 1 diabetes (which is now a curable disease) simply because they cannot afford the $100,000 cure and insurance won't cover it unless you have a gold-plated healthcare plan. That's a function of the lame U.S. sick-care system, so for the immediate future after this cure is found, I will (and many others will) still have our work cut for us. JDRF Walks will still be to cure diabetes, but instead work to bring the cure to the many who cannot afford it. The good news: they remain as popular as ever, and they do a damn good job. Within 5-7 years, nobody (in the U.S. or Canada, anyway) diagnosed with type 1 diabetes will have to suffer because they cannot afford the cure.

By that time, I'll be in my early 60's, and approaching retirement. The good news is that I've planned pretty well for my retirement, so unlike much of the Baby Boom which is not well-prepared for retirement and planned to live on the equity in their homes, I should have enough to spend my golden years without too much worry about money. Yes, I will have to live on a fixed-income, but I should be well-prepared, and without a money pit like type 1 diabetes to worry about, I can spend my retirement years pursuing other causes with my time.

Top on my list will be working to prevent any chronic disease. Unfortunately, because medicine no longer cures any diseases, just treats them for perpetuity, there's plenty to do!

While some of the D-OC is still around to work on it, sadly, many have decided to become typical retirees, pursuing early-bird specials and moving to senior condo complexes in places like Florida and Arizona. But many retirees have been priced out of retiring in the U.S., so they stretch now their retirement funds further by moving to places like Costa Rica, many places in the Caribbean, the Philippines, etc. That's a reality. Fortunately, the internet exists in these places, so we still do periodic chats online (no longer weekly, but every few months).

While I work to prevent more chronic illnesses, time passes, and I'm getting old. I'm now a genuine senior citizen. Sadly, many of us are getting old. Some live with their children, others health is ailing for reasons other than diabetes. A few have Alzheimer's and no longer remember life before a cure, or even their families. They are still the minority. The rest of us reminisce about the old days before a cure, and before everyone had access to a cure. We still chat online, although nowadays it's video conferencing and we do it with our mobile devices which we wear like a visor.

Now I hate to think about it, but someday, we'll all die. But the days we complained about life with diabetes are happily a distant memory. We call them the "bad old days"!! But many of us still have "Sprinkles" stuffed animals sitting on our beds today to remind us never to let chronic diseases happen to anyone ever again!

Diabetes Blog Week Day 4: And Top on 10 Things I Hate About Diabetes Are ...

Before writing today's Diabetes Blog Week topic du jour, I actually read a fair number of my fellow PWD's blog posts (see HERE for all of them) on today's topic (see HERE for the entire week's topics, and for my posts from Day 1, Day 2 and Day 3).

Today's Assignment: Ten things I hate about you, Diabetes – Thursday 5/12: Having a positive attitude is important ... but let’s face it, diabetes isn't all sunshine and roses (or glitter and unicorns, for that matter). So today let's vent by listing ten things about diabetes that we hate. Make them funny, make them sarcastic, make them serious, make them anything you want them to be!!

Interestingly, avoiding injections was not top on anyone's list -- in fact, fingersticks associated with testing are/were much more consistently mentioned. Yet, to those who do not live with diabetes, that's ALWAYS what outsiders believe we all want. Venture capitalists and angel investors in biotech companies seem to believe it, too, and they've poured millions (billions?) into largely failed efforts. I wonder when they'll get a clue?!

Sure, a few people with diabetes noted that they're sick of all the piercing, pricks, injections and the like, but it's almost always part of a combined dislike for all the bull$#!t that goes along with this disease.

Here's a news flash for investors: before investing money, try actually speaking to people who live with the disease, and if the investment involves the hormone insulin or insulin receptor ligands as they FDA calls them (meaning analogues), you had better be dam sure that you have appropriate representation for people who live with type 1 diabetes, because we constitute at least 75% of all the current insulin users according to the U.S. Centers for Disease Control (CDC), even though we're probably only 10% of patients with diabetes because there is no other treatment option.

This brings me to one the ten things I HATE about diabetes. While Picking just 10 is really more like picking the worst of many evils, I am sharing 10 of my dislikes about this disease.

Top on my list: widspread ignorance among the investment community about what constitutes an "unmet clinical need" (I'll give you a hint: don't only speak to doctors about this!). Avoiding injections usually isn't on the list, except among the newly-diagnosed who have yet to realize that's the easiest part of managing diabetes -- really. Also on that list should also be any new drug or insulin that delivers marginal improvement in glycemic control (were talking a few basis points in HbA1c reductions). Sorry, that doesn't warrant a big increase in expenditures, either, and with healthcare budgets under incredible scrutiny on a worldwide basis, it might make for a tough sell, too.

A recurring theme that seems to be routinely written-off, ignored or otherwise dismissed as insignificant actually WAS avoiding hypos. That means insulin that cannot cause hypos. Beyond SmartCells (see my interview with the CEO HERE, which was recently acquired by Merck last December (see HERE), there's at least one Canadian company working on it known as Dibecore Medical, Inc. of Toronto, although there have been few details about the company's Hypoguard Insulin which was still in preclinical trials. I have no other knowledge about this, so don't ask!

Beyond that, in no particular order:

2. Doctors who say "we" when discussing MY diabetes. You know the statements "How is 'OUR' diabetes?" or "What are 'WE' going to do about this HbA1c?" Please. I see my endo for rougly 15 minutes every quarter. He may make a few suggestions, but unless he's going to take responsibility for when things don't go right, don't try and get cute and call it "our" diabetes, when we all know they have little real ownership for it.

3. I'm stealing this next one from Kelly at Diabetesaliciousness(TM):

Insurance companies who dictate how many test strips a person is allowed to use per day.
NEWS FLASH: Diabetes is not a one size fits all disease, nor is it the same disease two days in a row.
Some day require more testing, PERIOD.

And speaking of insurance companies - SCREW your pre-existing conditions clause.
Being an asshole is absolutely a pre-existing condition but being an @$$shole doesn't get you penalized regarding a pre-existing health insurance clause.
Look, you can't tell me that being an asshole isn't a pre-existing condition, because I know for a fact that it is.

4. This next one is for all of my fellow PWD's who think they have broken pancreases and keep saying this. Guess what, your pancreas still works, only your islets and beta cells are broken. The beta cells which make insulin (and amylin) actually constitute less than 1% of the mass of the pancreas, and while we're accustomed to thinking about it this way, glucose metabolism is NOT the only function of the pancreas. It does a lot for digestion, too!

5. I hate biosynthetic insulin and it's analogues. I've written about this in the past, so I won't bore you with it here, but let's just say that today's insulin analogues are no closer to human insulin than porcine insulin many of us used without problems when diagnosed, and there have been a number of comprehensive meta-analyses (in the UK, Germany, and Canada just to name a few) on the clinical trials for all analogues, most of which raise questions just how much better this overpriced, new insulin really is. Some people like it, and I'm happy for them, but I did pretty dam well on the old stuff, and have suffered from hypo unawareness since this fancy new shit arrived. The UK organization the Insulin Dependent Diabetes Trust (IDDT) has a boatload of data supporting the evidence the manufacturers tried to bury. (see my book review of Invisible Frontiers for more HERE) They pulled the old stuff off the market for one reason: fatter profits. Fuck you, big pharma. I can't wait for tons of new competitors to start eating your lunch!

6. Test strips, their lack of accuracy and high price tags. The manufacturers make a tidy profit on this strips that aren't even all that accurate. They do everything in their power to make excuses on why they can't, when we all know it's about potecting the bottom line. That, along with the total cost of being a PWD. I'm not made of cash, and for whatever reason, the medical profession seems to respond to diabetes management with a "money is no object" behavior. I cannot even get a freaking CGMS monitor covered, and I had to fight to get my prescribed number of test strips. Any bets on what you'll go through to get an artificial pancreas covered?!

7. Insulin "Pump Evangelists". I didn't make this term up, but suffice to say, it's not a term of endearment. Many people love their pumps, but just remember, it does not eliminate diabetes and it IS possible to do just fine on multiple daily injections (I do, as do many people in Europe who love their insulin pens). See HERE for more background.

8. Did I mention all the $#!t I have to carry around? WTF. I'd like to be able to go out without carrying a fucking suitcase once and a while, diabetes. (For more, see HERE)

9. The mass market media. Editors who cut key facts from stories about diabetes to fit a headline in, while perpetuating misinformation. Soundbytes for the dumbing of America and people whose primary information comes from watching Oprah (the Dr. Oz diabetes debacle was on her watch).

10. I'm stealing this one from George "Ninjabetic" Simmons (see HERE): I hate you (diabetes) for the fact that the person reading this either has you or someone they love has you.

So there you have it, and although I just made it before midnight, Google's Blogger was not cooperating (don't believe me, see HERE) so this is going up late! Seriously, work is really keeping me busy this week, and blogging, while I enjoy it, has required a genuine committment from me this week, but I really have tried to participate.

By the way, this isn’t diabetes-related, but I cannot STAND people who send me Facebook friend requests (who I don’t even know) and don’t have the courtesy of writing anything in the request. If we’ve never met face-to-face, and I don’t know anyone you know, what makes you think I want to add you to my list of FB friends? That’s called common courtesy, folks!

Wednesday, May 11, 2011

Diabetes Blog Week Day 3. Major Dia-Blunders, Diabloopers.

For today's topic in Diabetes Blog Week (see HERE for the different topics and wildcard subjects, and HERE for my post on the first day, and HERE for Day 2).

Whether you or your loved one are newly-diagnosed or have been dealing with diabetes for a while, you probably realize that things can (and will) go wrong. (that's part of life with a chronic disease) Sometimes the things that go wrong aren't stressful – instead sometimes they are downright funny! Go ahead and share your Diabetes Blooper – your "I can't believe I did that" moment – your big "D-oh" – and let's all have a good laugh together!!

I wish my bloopers were funny, but they usually aren't. But I've done them, and others might laugh at the sheer stupidity of them, or maybe empathize.


-Not being sure if I've dosed or not. That sucks, and I use waaaay to many test strips to figure it out. It's one time I wished I did use a Humapen Memoir or pump so I had a record of whether I dosed or not!


-Poking finger for blood test without putting a strip in the meter. Done that many times, usually I can just wipe it clean, put the strip in fast, and then squeeze my finger again. But it still sucks!


-Mixing up my Levemir and Humalog (dialing the wrong pen, just not paying attention) and taking a big dose of the wrong insulin. Luckily I test a lot and figured it out. But that resulted in an entire half-day eating sugar, Pepsi, apple juice ... you name it, even using up my glucagon pen, too (that's OK ... I guess it's better to use them once and a while!) Not fun, until it's done and can look back at it and laugh.



-Leaving home with an empty pen or no test strips. Done that, too. It blows, ruining the day. I have backups in the fridge at work, but it still sucks.

Anyway, there's been plenty of screw-ups over my 34 years with type 1, but I try to keep them to a minimum. Hopefully you'll find them funnier than I did at the time!

Tuesday, May 10, 2011

Diabetes Blog Week: Letter Writing Day


For today's topic in Diabetes Blog Week (see HERE for the different topics and wildcard subjects, and HERE for my post on the first day). Today's topic was borrowed from a February Wego Blog Carnival that asked participants to write letters to their conditions.

Particpants can write a letter to diabetes if they'd like, but the Diabetes Online Community was also taking it one step further. The suggestions: "How about writing a letter to a fictional (or not so fictional) endocrinologist telling the doctor what you love (or not) about them. How about a letter to a pretend (or again, not so pretend) meter or pump company telling them of the device of your dreams? Maybe you’d like to write a letter to your child with diabetes. Or a letter from your adult self to the d-child you were. Whomever you choose as a recipient, today is the day to tell them what you are feeling."

Wow!! Really.

I wish this was the topic all week, and certainly on day one, because I could write letters to so many parties, which can be incredibly therapeutic in it's own right. My letter to type 1 diabetes would certainly NOT be a love letter. I love nothing about diabetes, and it has sucked so much joy and happiness from so many lives in spite of reasonably good glycemic management. You can have all the inputs correctly, and still not get the outcome it is supposed to yield. WTF is that all about? I would describe diabetes kind of like having a second anus that could not truly be controlled, so get your Depends adult diapers ready!!

But I'm not going to do that today. Frankly, I have sooooooo much going on at work that I will be spending most of my evening finishing up several projects that are due in the next few days. As a result, I may still revisit this idea of writing letters again when time permits, but today I am going to write a letter to the Diabetes Online Community. Read on for more ...




Dear Diabetes Online Community,

First, thank all of you. This community has provided me and countless other individuals with diabetes with far more than the medical profession acknowledges. Perhaps the biggest contribution has been, for me anyway, the mental therapy you provide. I don't have to explain how managing type 1 diabetes frequently does not follow rules it's supposed to. Or how doctors have this insane notion that simply following the rules will yield consistently predictable outcomes. Or why the clinical question medicine SHOULD be answering is not why so many individuals with diabetes suffer from depression, but rather why a majority manage to escape depression?

My letter tonight is short and sweet. But I appreciate all of you and hope that collectively, we will be able to someday prove the clinical worth of having a community such as ours. The benefits are indeed genuine, and we will prove it someday, even if we don't have a medical journal submission ready today!

Beyond that, I will continue to enjoy our daily Twitter communications, weekly chats via Twitter on Wednesday evenings, reading your blogs daily, the radio show on BlogTalkRadio, pehaps video chats online at MyMeetingHub.com (Note: MyMeetingHub's services were discontinued at 9PM on October 30, 2011, but alternatives have emerged, such as Google Plus Hangouts enable video chats for up to 10 people ... on the fly) ... who knows what tomorrow might bring?!

I really must sign off now. Stay tuned for another letter (or two) at some point in the future!

Regards,
Scott Strumello

Monday, May 09, 2011

D-Blog Week: Admiring Our Differences

My friend and fellow college alum (the irony is we didn't really know each other until we met via the D-OC!) Karen Graffeo at "Bitter-Sweet" had an idea last year to do Diabetes Blog week and recruit a bunch of fellow diabetes bloggers to participate. Needless to say, last year's event proved to be very popular and successful, so she's decided to do it again this week, which marks the second annual diabetes blog week.


The topic du jour (Monday, 5/9/2011) is Admiring our differences. Although like last year, there is an option for wildcard posts within a few, pre-defined topic ranges. The basic overview of today's topic is as follows (in Karen's words): We are all diabetes bloggers, but we come from many different perspectives. Last year, Diabetes Blog Week opened eyes to all of the different kinds of blogs (and bloggers) out there – Type 1s, Type 2s, LADAs, parents of kids with diabetes, spouses of adults with diabetes and so on. Today let’s talk about how great it is to learn from the perspectives of those unlike us! Have you learned new things from your T2 friends? Are D-Parents your heroes? Do LADA blogs give you insight to another diagnosis story? Do T1s who've lived well with diabetes since childhood give you hope? Pick a type of blogger who is different from you and tell us why they inspire you - why you admire them - why it's great that we are all the same but different!!

I must admit that when I first began blogging about type 1 diabetes way back on September 15, 2005, I wasn't really looking for people who were different from me -- in fact, I was looking for quite the opposite -- I was looking for patients who were just like me, and indeed, I found them! Of course, in those days, the Diabetes Online Community was still very much in it's infancy.

For example, it would be a fair number of months before David Edelman of Diabetes Daily would create a widget with blog post "headlines" from fellow members of the diabetes blogging community, so in those days, simple blog searches and word-of-mouth were the way this community really began. Also, an early crash in the Diabetes Daily headline feed proved to me at least that my own blogroll would prove to be as important as a third-party source, a practice I have maintained since then!

Among the earliest bloggers I remember on the topic of diabetes included at least a few who remain with it today (more than six years later), although many of us have subsequently acquired our own domain names, changed hosts, blog designs and whatnot. Keeping track of all the changes is an ongoing job! I won't mention any names of the early bloggers specifically (I think most of you know who you are already) and we've been fortunate to have a dynamic and ever-expanding number of great new members in this community, each of whom have added in ways that are impossible to articulate in just a few words.

But the topic for today is more about admiring our differences.

Of course, here's where I may deviate a bit from Karen's perspective just a bit on the topic. My perspective as one of the d-blogger veterans out there is that collectively, I think the community has learned a lot more about respect for one another over the last 6 years.

In the early days, many (or all?) diabetes internet message boards would have regular debates (monthly or even weekly) about the differences between type 1 and type 2 and why one group didn't want to be associated with the other. Often, those debates would end up with insults or annoyances for failure to appreciate the challenges on either side of an issue, and just when I thought the debate had been put to rest, another one would re-emerge with the same basic discussion.

Learning From Each Other, and Hopefully Learning Mutual Respect

Since that time, I can say that I think the incidence of these "debates" have subsided dramatically. They still flame up every now and then, but it seems that the interest in participating in those debates has subsided a lot. Instead, I have seen a lot of growth within the community where even if participants don't share a perspective, today it doesn't end up (at least not as often as it used to) in insults or flame wars.

Much of credit for that, if I may be so bold, really belongs to two things: first, a few, brave type 2 bloggers who have gone a long way towards venturing in a community that so far, remains disproportionately stacked with type 1 bloggers. But as important, I think the community has collectively no longer seems interested in debating about which type of diabetes is more challenging or finds it easier to manage or take care of. The bottom line is clear (it should have been all along, but no one ever said there would not be a learning-curve, apparently): no person asked for diabetes, and while the challenges are unique to the individual in managing diabetes, it's a full-time job that never goes away. Similarly, no form of diabetes can be eradicated with some kind of diet or exercise plan. In fact, the medical establishment is clear that medically, cure may be defined as restoration to good health, while remission is defined as abatement or disappearnace of the signs and symptoms of a disease, hence at present, the only option for any type of diabetes is to put their disease into remission. In summary, the type 2 bloggers who have braved a blogging community that is disproportionately type 1s in the online community, as well as the community's willingness to hear different perspectives and lack of willingness to turn the conversation into a debate has enabled me and many others to admire our differences.

Collectively, I would say this has been one of the D-OC's greatest accomplishments to date!

D-Blog Week: Admiring Our Differences

My friend and fellow college alum (the irony is we didn't really know each other until we met via the D-OC!) Karen Graffeo at "Bitter-Sweet" had an idea last year to do Diabetes Blog week and recruit a bunch of fellow diabetes bloggers to participate. Needless to say, last year's event proved to be very popular and successful, so she's decided to do it again this week, which marks the second annual diabetes blog week.


The topic du jour (Monday, 5/9/2011) is Admiring our differences. Although like last year, there is an option for wildcard posts within a few, pre-defined topic ranges. The basic overview of today's topic is as follows (in Karen's words): We are all diabetes bloggers, but we come from many different perspectives. Last year, Diabetes Blog Week opened eyes to all of the different kinds of blogs (and bloggers) out there – Type 1s, Type 2s, LADAs, parents of kids with diabetes, spouses of adults with diabetes and so on. Today let’s talk about how great it is to learn from the perspectives of those unlike us! Have you learned new things from your T2 friends? Are D-Parents your heroes? Do LADA blogs give you insight to another diagnosis story? Do T1s who've lived well with diabetes since childhood give you hope? Pick a type of blogger who is different from you and tell us why they inspire you - why you admire them - why it's great that we are all the same but different!!

I must admit that when I first began blogging about type 1 diabetes way back on September 15, 2005, I wasn't really looking for people who were different from me -- in fact, I was looking for quite the opposite -- I was looking for patients who were just like me, and indeed, I found them! Of course, in those days, the Diabetes Online Community was still very much in it's infancy.

For example, it would be a fair number of months before David Edelman of Diabetes Daily would create a widget with blog post "headlines" from fellow members of the diabetes blogging community, so in those days, simple blog searches and word-of-mouth were the way this community really began. Also, an early crash in the Diabetes Daily headline feed proved to me at least that my own blogroll would prove to be as important as a third-party source, a practice I have maintained since then!

Among the earliest bloggers I remember on the topic of diabetes included at least a few who remain with it today (more than six years later), although many of us have subsequently acquired our own domain names, changed hosts, blog designs and whatnot. Keeping track of all the changes is an ongoing job! I won't mention any names of the early bloggers specifically (I think most of you know who you are already) and we've been fortunate to have a dynamic and ever-expanding number of great new members in this community, each of whom have added in ways that are impossible to articulate in just a few words.

But the topic for today is more about admiring our differences.

Of course, here's where I may deviate a bit from Karen's perspective just a bit on the topic. My perspective as one of the d-blogger veterans out there is that collectively, I think the community has learned a lot more about respect for one another over the last 6 years.

In the early days, many (or all?) diabetes internet message boards would have regular debates (monthly or even weekly) about the differences between type 1 and type 2 and why one group didn't want to be associated with the other. Often, those debates would end up with insults or annoyances for failure to appreciate the challenges on either side of an issue, and just when I thought the debate had been put to rest, another one would re-emerge with the same basic discussion.

Learning From Each Other, and Hopefully Learning Mutual Respect

Since that time, I can say that I think the incidence of these "debates" have subsided dramatically. They still flame up every now and then, but it seems that the interest in participating in those debates has subsided a lot. Instead, I have seen a lot of growth within the community where even if participants don't share a perspective, today it doesn't end up (at least not as often as it used to) in insults or flame wars.

Much of credit for that, if I may be so bold, really belongs to two things: first, a few, brave type 2 bloggers who have gone a long way towards venturing in a community that so far, remains disproportionately stacked with type 1 bloggers. But as important, I think the community has collectively no longer seems interested in debating about which type of diabetes is more challenging or finds it easier to manage or take care of. The bottom line is clear (it should have been all along, but no one ever said there would not be a learning-curve, apparently): no person asked for diabetes, and while the challenges are unique to the individual in managing diabetes, it's a full-time job that never goes away. Similarly, no form of diabetes can be eradicated with some kind of diet or exercise plan. In fact, the medical establishment is clear that medically, cure may be defined as restoration to good health, while remission is defined as abatement or disappearnace of the signs and symptoms of a disease, hence at present, the only option for any type of diabetes is to put their disease into remission. In summary, the type 2 bloggers who have braved a blogging community that is disproportionately type 1s in the online community, as well as the community's willingness to hear different perspectives and lack of willingness to turn the conversation into a debate has enabled me and many others to admire our differences.

Collectively, I would say this has been one of the D-OC's greatest accomplishments to date!