Type vs. Type
I was at a church function some years back, when I was a still a desperate thirty-something single, and a well-meaning person introduced me to a single man. I fluttered. I smiled. The introducer mentioned that we had diabetes in common.
Single man smiled back and asked, “Are you a real diabetic?”
I wasn’t sure what to think. What an odd question. I answered, “Yes, I’ve been officially diagnosed with diabetes.”
I think now that this was his code for “Are you a type 1 diabetic like me?” But, I have to say, I don’t much care for the implication that Type 1s have real diabetes and Type 2s have some shoddy imitation. I’m working on my impersonations, daily, and they seem pretty real to me. If I’ve got a knock-off, it looks like the real thing. Needless to say, there were few additional conversations between him and me.
Now, I know that this schism between types is in part 1) an accident of naming and 2) caused by the historical development of medicine and human knowledge. If this were not such an ancient disease, or if the two diseases, caused by very different mechanisms, did not have such similar symptoms, the two diseases would have very different names. Like Castor and Pollux. Sampson and Delilah. Bubble and Squeak.
If there were more distinct names, the two types of us would not be all thrown in together in the same bucket. We’d have different national organizations. We’d not be competing for the same funding dollars.
And I know how traumatic Type 1 is. It has much more immediate life-threatening potential. Its discovery is often at a crisis point. Type 1s get hospitalized at diagnosis. Type 2s just walk out of the doctor’s office with a stunned look on their faces. Type 1 and its insulin requirements alter the entire family dynamic, especially if child is very young at diagnosis.
Type 1s are victims of an autoimmune or allergic reaction. It’s totally beyond their control. Type 2s are, according to stereotype, lazy fat old people. They just need to eat less and move more. Type 1s wear medical id tags. Type 2s smile shyly and say they have “a touch of sugar”. Type 2s can ignore their disease for years. Type 1s cannot ignore it for long, not without losing consciousness, and maybe even their lives.
And there is great hope for Type 1s, that there may be a cure for those who already have it, and perhaps soon an immunization to prevent its occurrence. May this generation of Type 1s be the last generation of Type 1s.
But both diseases are capable of killing us. They are also capable of maiming us. We must fight diabetes, whichever type, and seek as healthful a life as we are capable of living.
So, good news for Type 2s. I say, rise up, embrace your inner diabetic. We must become empowered diabetics! Type 2s deserve plenty of attention for our disease. Here are my points (finally):
1) There are many, many more of us Type 2s than there are of you Type 1s. With good military planning, we can take them.
2) For the most part, we Type 2s are older than those Type 1s are. What’s the saying I’m reaching for? Something about old age and treachery overcoming…. I’ll think of it in a minute I’m sure.
3) A Type 2 can become a Type 1, but the opposite is rarely true. We can infiltrate their ranks, learn their secrets.
4a) I think that the numbers are on our side. That is to say, the rate of Type 2 diabetes is explosive. I haven’t heard of a similar increase in the occurrence of Type 1s (thanks be to god).
4b) More and more young pups are being diagnosed with Type 2 rather than (or in addition to) Type 1. We’re edging into their demographic.
Type 2 diabetics, arise! We are everywhere.
Single man smiled back and asked, “Are you a real diabetic?”
I wasn’t sure what to think. What an odd question. I answered, “Yes, I’ve been officially diagnosed with diabetes.”
I think now that this was his code for “Are you a type 1 diabetic like me?” But, I have to say, I don’t much care for the implication that Type 1s have real diabetes and Type 2s have some shoddy imitation. I’m working on my impersonations, daily, and they seem pretty real to me. If I’ve got a knock-off, it looks like the real thing. Needless to say, there were few additional conversations between him and me.
Now, I know that this schism between types is in part 1) an accident of naming and 2) caused by the historical development of medicine and human knowledge. If this were not such an ancient disease, or if the two diseases, caused by very different mechanisms, did not have such similar symptoms, the two diseases would have very different names. Like Castor and Pollux. Sampson and Delilah. Bubble and Squeak.
If there were more distinct names, the two types of us would not be all thrown in together in the same bucket. We’d have different national organizations. We’d not be competing for the same funding dollars.
And I know how traumatic Type 1 is. It has much more immediate life-threatening potential. Its discovery is often at a crisis point. Type 1s get hospitalized at diagnosis. Type 2s just walk out of the doctor’s office with a stunned look on their faces. Type 1 and its insulin requirements alter the entire family dynamic, especially if child is very young at diagnosis.
Type 1s are victims of an autoimmune or allergic reaction. It’s totally beyond their control. Type 2s are, according to stereotype, lazy fat old people. They just need to eat less and move more. Type 1s wear medical id tags. Type 2s smile shyly and say they have “a touch of sugar”. Type 2s can ignore their disease for years. Type 1s cannot ignore it for long, not without losing consciousness, and maybe even their lives.
And there is great hope for Type 1s, that there may be a cure for those who already have it, and perhaps soon an immunization to prevent its occurrence. May this generation of Type 1s be the last generation of Type 1s.
But both diseases are capable of killing us. They are also capable of maiming us. We must fight diabetes, whichever type, and seek as healthful a life as we are capable of living.
So, good news for Type 2s. I say, rise up, embrace your inner diabetic. We must become empowered diabetics! Type 2s deserve plenty of attention for our disease. Here are my points (finally):
1) There are many, many more of us Type 2s than there are of you Type 1s. With good military planning, we can take them.
2) For the most part, we Type 2s are older than those Type 1s are. What’s the saying I’m reaching for? Something about old age and treachery overcoming…. I’ll think of it in a minute I’m sure.
3) A Type 2 can become a Type 1, but the opposite is rarely true. We can infiltrate their ranks, learn their secrets.
4a) I think that the numbers are on our side. That is to say, the rate of Type 2 diabetes is explosive. I haven’t heard of a similar increase in the occurrence of Type 1s (thanks be to god).
4b) More and more young pups are being diagnosed with Type 2 rather than (or in addition to) Type 1. We’re edging into their demographic.
Type 2 diabetics, arise! We are everywhere.
7 Comments:
At 5:55 PM, If not a mother... said…
ahhh, so that's another thing in common, huh?
(Though I met my type 1 husband years before I was diagnosed.)
At 11:25 AM, Jane said…
I'm still laughing. Bring it on!
At 12:40 PM, Kerri. said…
Will there be a steel cage match? Oooh, maybe some tag-team, off the top rope action?
(I can't admit to having watched wrestling as a little, but I will say that my Jimmy "The Superfly" Snookah doll was classic...)
At 4:05 PM, Anonymous said…
a type 2 cannot become a type 1
whether on insulin or not type 2 diabetes is called NIDDM
non-insulin dependent diabetes mellitus
the difference is requiring insulin to control blood sugars and stave off heart disease, stroke, nephropathy
and requiring insulin to stave off acute illness and ultimately death
that is a big, and common misconception that when a type 2 goes on insulin they are making the transition to type 1
Obviously both diseases are scourges and the more sobering statistics behind ‘diabetes’ mainly reflect the type 2 epidemic i.e. life expectancy of 24 yrs, kills more than breast cancer and aids combined (in the US) consistently among the top five leading causes of death (in the US) this all reflects type 2 which effects somewhere around 1/10 and not type 1 that reflects somewhere around 4/1000
At 6:29 PM, Kassie said…
I think we can settle this with a round of rock, paper, syringe...
this was awesome!
At 1:29 PM, Lori Rode said…
I strongly dislike anonymous commenters. Yuck.
I did not mean to imply that using insulin as part of one's type 2 diabetes controls means that every type 2 who uses insulin is or becomes a type 1.
But indeed, there do seem to be some type 2s who may develop into the 'dead islet cells' type of diabetics. At least, that's what some folks keep telling me. Perhaps it's not true. I'll have to do more research. When I have a minute.
At 11:29 PM, Anonymous said…
It is called LADA or LADY or LADC latent autoimmune diabetes of adulthood / youth / childhood and it is a form of type 1 diabetes, this is why in certain situations it is important to test for anti islet cell antibodies. LADA is often misdiagnosed as type 2, or sometimes gestational because it shows up on a glucose challenge
Type 1’s can develop what is called double diabetes with insulin resistance, so in a sense a type 1 can indeed become type 2. It is accepted clinical practice for some type 1’s to take metformin etc.
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