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Re: [IP] Re: birthday parties & Type II Amy

In a message dated 7/24/99 5:07:55 PM US Eastern Standard Time, 
email @ redacted writes:

<< Last week I met a Type II diabetic woman at a 'Disabled Meeting' which was 
sort of a social event with refreshments.  This woman has neuropathy so bad 
she's in a wheel chair , yet was going on and on about how she won't drink 
diet drinks because she thinks the taste is horrid. (snip) She then proceeded 
to down one of those huge sport's bottles full of regular coke. Then refilled 
it and had another! She must've had 2 litres of the stuff.  She was confiding 
to me all her fears about going on 'the needle'. (snip)  I thought, but 
didn't say, she might be amazed at how much better she feels when she starts 
MDI which it sounds like her doc is threatening her with.  I tried to be 
supportive but couldn't help but think, she's giving the rest of us a bad 
name. >>


First of all, I have type 2 diabetes. I was DX'd in 1986 *after* I told my 
doc I thought I might have DM (thirsty and peeing all the time). He laughed 
at me, but ordered a test anyway. I was 311 fasting. My education? "Here. 
Follow this (thrusting a piece of paper at me with a diet printed on it). 
Don't eat any sugar."

That's all I knew for the next nine years, as my A1c climbed to somewhere in 
the neighborhood of 13.5. Then I was put on oral meds (another doc) and told 
to test my sugar. I wasn't told how to test (the meter came with a video 
tape, which is how I learned). I wasn't told what to look for. I wasn't told 
what was "normal." I wasn't told how to align the numbers so I could see 

After about a year of that (and being raged at for being "non-compliant"), I 
landed in a cardiac monitoring unit with chest pains. And took my first shot 
of insulin. I told me doc I wanted to go on insulin, so I was sent to an 
educator who taught me how to draw up insulin. Period. My BGs were still 
erratic (and high most of the time). 

"Finally*, a friend of mine told me about a doctor called an 
"endocrinologist." He was in a group that had in-house dietiticans, nurse 
educators, etc. -- and I *finally* began to learn about DM. More importantly, 
they asked me what my lifestyle was and worked with me to fit DM in. BTW, 
this was also the first time I was told that all carbohydrates converted to 
sugar when eaten. Since then, my A1cs have consistently been in the sixth 

When I asked my endo about going on MDI, the first words out of his mouth 
were, "But you're a type 2." (I got my MDI.)

And when I asked about a pump, the first words out of my endo's mouth 
(different endo) were, "But you're a type 2." (I got my pump, but it took six 
months of convincing the endo.)

I don't consider myself to be a stupid person. And, in fact, I'm a reporter, 
which means I do research all the time. But I didn't think to research my own 
disease. I relied on the docs and they didn't tell me about DM, either. I've 
since met a college president and several professors who also didn't know 
about DM -- weren't told; didn't think to do the research. So I don't feel so 
bad any more.

Earlier today, the local endo (not the one I go to) was at my house for lunch 
(which was *not* cooked out of the ADA cookbook LOL), talking about his 
efforts to get his physicians group and affiliated hospital to open a 
diabetes education clinic and about the resistance he met. Seems they don't 
see the need for diabetes education. (It will, BTW, open in October -- half 
funded, with scrounged furniture.)

I suppose what I'm trying to say is to not totally blame the type 2 woman you 
met. It's been my experience that type 2s are rarely told anything about DM 
aside from "watch what you eat" or "here, follow this" with no further 
instruction. They don't know anything because their docs haven't told them 
and haven't referred them to an educator. Sadly, they also don't know that 
they don't know anything. They may need to take insulin (as I did) but, 
because they're type 2, their docs may believe that a pill should help them 
*if only they'd be compliant*!

Docs also tend to "threaten" type 2s with insulin, instead of explaining DM, 
how it works, and why insulin is needed. I think that attitude causes a lot 
of fear -- fear of having to take shots and fear that you've had to go to 
insulin because you've been "bad" and because your disease has gotten 

When I run into situations as described in Dianne's note, I try to gently do 
a little education. I recommend a book. I recommend seeing an endo. I know 
you all will correct me if I'm wrong <g>, but it seems to me that people with 
type 1 DM get a bit more education than the average type 2. So when you meet 
a type 2 who's chugging liquid (no matter whether diet or not), you might 
want to suggest *why* s/he is so thirsty. Try to understand that there may be 
a huge lack of knowledge. And try to gently nudge them toward a place that 
will teach. It may be the doc who's giving "us" a bad name.


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