Type 1 in a Type 2 World
What not to say to someone with type 1 diabetes.
Similarities and Differences continued...
In type 2 diabetes, the pancreas still makes insulin, but the body cannot use it properly. The pancreas responds by making more, until it eventually loses its ability to generate the hormone. People with type 2 may eventually have to take insulin, but early on in the disease, they usually take oral medications only and can sometimes control it with diet and other lifestyle changes alone.
Type 2 has a strong genetic component, and obesity and poor diet often play a role in developing the disease. It was once known as adult-onset diabetes, but as the childhood obesity epidemic increased, more and more children began to develop type II, so the name was changed.
Source of Stigma
That fact -- the obesity-diet-exercise connection -- lies at the heart of the battle over type 1 vs. type 2. Many people with type 1 diabetes feel that they're being unfairly stigmatized as having brought on their disease with an unhealthy lifestyle.
Wendy Conway's daughter, Abby, was diagnosed with type 1 diabetes one month after her fourth birthday. Like Andrea Kolligian, they've heard a lot of judgmental messages about weight and lifestyle. "There are a lot of assumptions," Conway, who lives in Boston, says. "When people find out she has diabetes, they say ‘Oh well, she's not heavy,' or ‘Did you give her too much sugar?'"
"I have had people to this day tell me what I should and should not eat," says Susan Manser of Manchester, Conn., who was diagnosed with type 1 diabetes at age 4. Her twin sister, diagnosed a day before Susan, died of kidney failure in 1993. "They tell me I am cheating, but they do not realize I use an insulin pump," Manser tells WebMD in an email. "I count carbs. I watch what I eat and work with my endocrinologist to ensure I am doing all I can to stay healthy."
In spring 2010, an article on the Diabetes Health web site, "What People with Type 1 Diabetes Can Learn from Type 2s," sparked a firestorm of controversy, with many comments in response. Author Clay Wirestone wrote that, "in weaker moments," people with type 1 diabetes "look down your noses" at those with type 2. He suggested that type 1s, who must control their disease with insulin, should devote themselves to exercise and a healthy lifestyle in the same way that type 2s must do.