What’s Your View of Type 1 Diabetes?

It happens to me a lot, and I’ll bet it’s the same for others with type 1 diabetes. Someone says, often after finding that I inject insulin, “oh, you have ‘bad’ diabetes.” There are many possible discussions wrapped up in that phrase, not the least of which is the notion that treating with insulin is reserved for “bad” cases. That is a misperception that causes great anxiety for type 2 patients to whom insulin therapy is recommended, and may cause some to reject the most effective therapy there is (insulin). I want to discuss an unspoken part of that “type 1 diabetes is ‘bad’ diabetes” concept, however – whether some people with type 2 diabetes assume they have “good” diabetes.

Granted, type 1 diabetes typically has some increased risks, and more demanding routines. We must take insulin, and even though insulin is extremely effective it does carry a risk of dangerously low blood glucose levels. And, we have increased risks for dangerously high blood glucose levels too with diabetic ketoacidosis, something people with type 2 rarely experience even with identically high blood sugar.

I would contend that we have some advantages too. For one thing, since type 1 diabetes usually begins at a young age I suspect we find lifestyle changes easier to adopt – we haven’t spent decades developing our habits. But more to the point, it is really impossible to ignore type 1 diabetes – to assume it’s not a serious health condition. And, that’s what concerns me about the potential for “type 2 diabetes is ‘good’ diabetes” thinking – it is often possible to ignore type 2 diabetes for a long time. The American Diabetes Association estimates that 8 million people have diabetes that hasn’t even been diagnosed, and I can assure you only a miniscule number of those would be type 1.

What’s my point? Just because you’re ignoring diabetes doesn’t mean diabetes is ignoring you. There is no “good” diabetes, and we are all by and large at risk for the same unfavorable outcomes called complications. So, you can be glad that type 2 diabetes may be less demanding than type 1, but don’t let the absence of symptoms distract you from faithfully taking your medication, eating healthy, being active, getting enough sleep, and visiting your medical team regularly. Paying attention to our diabetes in these ways is the recipe for a long and active life for you and for me.

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