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[IP] Type II and Diabetes Education

I can see you have a gentle touch in educating others - you certainly educated me!  And I think of myself as pretty smart too! 

Really an excellent post and you're right I never did consider what kind of diabetes education my new 'friend' may have received.  After 34 years on insulin I can't believe that everyone hasn't had the same resources as I have.  And so many docs are just plain jerks!  (And some are great and come over for lunch!) I blush to think of my lack of sensitivity - especially since I go on and on about others.

Thank you for setting the record straight.


 ---- On Jul 24 email @ redacted wrote: 
> 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. >>
> Hi
> 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 
> patterns.
> 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 
> percentile.
> 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 
> "worse." 
> 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.
> Thanks,
> Jan
> ----------------------------------------------------------
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